Background: Food insecurity is an ongoing problem in the U.S. with implications for health problems and social disadvantages. Past food insecurity intervention studies have targeted barriers to accessing healthy food. Although, information barriers have not been adequately addressed by food insecurity interventions. Methods: This qualitative study involved testing a text message as an informational nudge through interviews among adults in the southwest U.S. (n = 10). Interview questions focused on the message content, persuasiveness, relevancy, clarity, and details that participants liked and disliked. A qualitative content analysis of interview responses then highlighted any necessary modifications to the text message. Results: Interview responses highlighted that the message conveyed details about how to access food assistance resources. The message was perceived as informative, clear, and friendly. Participants highlighted the need for better spacing in the message layout, more details about the Supplemental Nutrition Assistance Program (SNAP), and why SNAP is relevant. Conclusion: Text message readability and informativeness were common concerns raised during interviews. Participant-informed modifications to the text message were applied in preparation for using the message in a food insecurity intervention. Future food insecurity research efforts should similarly test novel interventions to ensure the intervention is acceptable for the target population.

Background: Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess influencing factors for adoption, implementation and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles’ quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. Methods: A systematic search was conducted in 7 databases with the following main inclusion criteria: 1) school-based interventions and 2) target group aged 5–14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 constructs within these domains were used to deductively analyze the data. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. Results: 6452 articles were screened, and 16 met all eligibility criteria. Included articles applied mixed methods (n=10), qualitative (n=5) and quantitative design (n=1). Of these, five were considered to report simple interventions and eleven were considered to report complex interventions. In total, 295 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain, and in the group of simple interventions not reported at all. In the inner setting, most reported influencing factors were time (n=7), scheduling (n=6) and communication (n=6). Conclusion: This review found a wide range of influencing factors for implementation. Most important influencing factors need to be assessed for every setting. Including all stakeholders involved in the implementation process enhances the prioritization of the most important influencing factors for the specific setting. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES.

This article addresses the question how the religious narrative identity and subjective religiosity change over the course of 15 years. The cases portrayed are deconverts who have changed their religious affiliations multiple times. It will be carved out what led to their deconversion and what remains as a core of their faith after they have turned away from organized religion for good. Interviews have been conducted at three time points and are analyzed using content analysis. It will become clear that the needs and expectations of the two individuals differ highly, as well as the reasons for turning away from a religious community; yet what is a common core in this joint faithful journey is their need to live their religiosity, now in a private setting.

The doctoral defense is an important step towards obtaining the doctoral degree. As such, preparing for the event is necessary. Anecdotal evidence highlights that there is a wide variety of ways in which doctoral candidates prepare for the defense. In this work, I want to explore if there is a relation between the way in which a doctoral candidate prepares for the defense and two important aspects of the defense: the outcome of the defense, and the student perception during and after the defense. For this purpose, I first reviewed the literature on the topic of the preparation for the doctoral defense. Then, I carried out an international survey on the doctoral defense and analyzed the data of the 204 completed surveys with respect to the preparation for the defense using quantitative and qualitative methods. The methods I used included the statistical tests of the correlation between on one hand the preparation and on the other hand the defense outcome and student perception. I used inductive thematic analysis of the open-ended survey questions to gain deeper insight in the way candidates prepared for their defense. I found that candidates most often prepare by making their presentation, reading their thesis, and practicing. The most effective measure is the mock defense, followed by a preparatory course. Reading blogs, books, and chapters is a less effective preparation measure. The conclusion of this work is that doctoral candidates need to understand the format of their defense in order to be able to prepare properly, and that universities should explore either individual pathways to the defense or pilots using a mock defense and/or preparatory course to give their doctoral candidates the necessary tools to prepare for their doctoral defense.

An introductory course of Arka Dhyana, also known as Intuitive Meditation (IM), consisting of five sessions, was offered to an international audience via Zoom technology. Participants were shown how to connect to their deeper self, essence or soul by bringing their I-ego-awareness from the thinking mind, often associated with the frontal part of the brain, to 19 energetic stations in the body including the heart centre. In this limited study, evaluation was both process and outcome orientated and included HeartMath (HM) Inner Balance or emWave2 electronic technology to measure mean coherence and achievement before and after each session. A highly significant increase in both coherence and achievement in six participants was found, which was also reflected in a reported increase in wellbeing related to feelings in qualitative statements indicating changes in levels of consciousness and individual transformative experiences as predicted by the Theory of the Six Main Levels of Consciousness.

Public participation is crucial in the process of urban governance in smart-city initiatives to enable urban planners and policy makers to take account of the real public needs. Our study aims to develop an analytical framework using citizen-centred qualitative data to analyse urban problems and identify the areas most needed for urban governance. Taking a Chinese megacity as the study area, we first utilise a web-crawling tool to retrieve public comments from an online comment board and employ the Baidu Application Programming Interfaces and a qualitative content analysis for data reclassification. We then analyse the urban problems reflected by negative comments in terms of their statistical and spatial distribution, and the associative factors to explain their formation. Our findings show that urban problems are dominantly related to construction and housing, and most frequently appear in industry-oriented areas and newly-developed economic development zones on the urban fringe, where the reconciling of government-centered governance and private governance by real estate developers and property management companies are most needed. Areas with higher land price and a higher proportion of aged population tend to have less urban problems, while various types of civil facilities affect the prevalence of urban problems differently.

By defining a constant probabilistic orbit of and iterated functions, the stability dynamics of these functions in possible interactions through connectivity provides the formation of a dynamic fixed point as a metric space between both iterated functions. The presence of a dynamic fixed point identifies qualitatively phases of iteration time lengths and interaction orbits of the event. Qualitative results show that the greater the average distance from one of the functions to the fixed point of the other (all possible solutions), the higher the iteration expression on time (false asymptotic effect) of one of the functions and in the opposite hand, the lower the average distance, the higher orbit’s interactions proximity between iterated functions (stability). This feature reveals asymptotic (well-defined) behavior between functions f and g within a well-defined Lyapunov stability.

Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients in risky situation because they then would find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, have also the opportunity to provide psychoeducation on the latest CAM scientific research to their clients. The current study aimed to explore knowledge and educational needs of CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs of CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were held at the PHCs where participants worked and interviews lasted for 55 minutes, on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants’ responses regarding CAM knowledge and educational needs. First (CAM understanding), participants’ responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants’ access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM essentially as part of Indonesian culture and it was therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants’ knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education.

The term “risk” is connoted with divergent meanings in natural hazard risk research and the practice of risk management. Whilst the technical definition is accurately defined, in practice, the term “risk” is often synonymously used with “danger”. Considering this divergence as a deficiency, risk communication often aims to correct laypersons’ understanding. We suggest in reference to Breakwell (2001) to treat the variety of meanings as a resource for risk communication strategies instead. However, there is no investigation so far, of what laypersons’ meanings of risk actually comprise. To address this gap, we examine the meanings of risk applying a social representations approach (Moscovici, 2001) in a qualitative case study design. Results of the study among inhabitants of Swiss mountain villages show that differences in meanings were found according to hazard experience and community size. We found commonly shared core representations, and single peripheral ones. We conclude with suggestions on how to make usage of the knowledge on SR in risk communication.

Non-pharmaceutical interventions (NPIs), including social distancing, wearing personal protective equipment, and lockdown measures, have been at the forefront of outbreak control in nursing homes. We used a mixed methodology to assess which NPIs nursing homes in the canton of Geneva, Switzerland, followed for their staff and residents during the first wave of the pandemic, between March 1, 2020 and June 1, 2020. For the qualitative component, we interviewed the attending physicians and/or director of each nursing home. Based on in-vivo codes, NPIs for nursing home workers and residents in each nursing home were thematically classified as: maximally restrictive, moderately restrictive, and minimally restrictive. In the quantitative component, we calculated incident rate ratios (IRR) for infection between the three levels of COVID-19-related measures taken in these nursing homes. We found an equal distribution of maximally (n=4), moderately (n=4), and minimally (n=4) restrictive NPIs. The extent of restriction did not show to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, p = 0.212 ; minimally restrictive IRR = reference). Variabilities in NPIs adopted by nursing homes, and the number of COVID-19 cases appear to be randomly affected.

Based on the multiple coordination framework of “promising government-effective market-ordered society”, this paper takes 68 cases of adding elevators to old buildings as samples, and selects six conditional variables: approval optimization, financial subsidies, financing innovation, technological innovation, capable people leading and neighborhood committee guidance. Using Crisp-Set Qualitative Comparative Analysis (csQCA), this paper discusses the combination of conditions that affect the success or failure. It is found that: approval optimization and neighborhood committee guidance are sufficient conditions for the success; successful cases can be divided into three types: “political and social dual-drive type”, “market and social dual-drive type” and “ternary co-drive type”; lack of approval optimization, lack of financing innovation, and the existence of capable people leading are necessary conditions for the failure. The failure cases can be divided into “government and market double failure type” and “market failure type”.

The Savu Sea holds significant importance as a conservation area in Indonesia, providing sustenance and livelihoods for local communities. It is situated within the Coral Triangle, a critical hotspot for marine biodiversity worldwide. However, the Savu Sea is currently facing various threats, including overfishing, pollution, and the impacts of climate change. Effective management of this conservation area relies heavily on the active participation of local communities. Therefore, this study aims to address this issue by analyzing how factors within these communities, such as the socio-economic condition of coastal households, environmental awareness, the existence of community-based conservation areas, attitudes towards activities within the conservation area, and participation in multistakeholder institutions, contribute to a positive perception of the benefits provided by the Savu conservation area. To determine the complex causal conditions that influence the outcome of perception, the study employs the Qualitative Comparative Analysis (QCA) method, specifically using crisp set QCA (csQCA). A survey was conducted among 22 coastal villages surrounding the Savu Sea, resulting in the identification of 14 different combinations of pathways that contribute to varying levels of perception regarding conservation. Valuable lessons can be drawn from this study to enhance the design of policies aimed at effectively managing the Savu conservation area.

One of the ramifications of the COVID-19 pandemic is that it has lent urgency to ongoing discussions on mental well-being. While standard techniques are available to diagnose mental health disorders such as depression, anxiety, and stress, ambiguity persists regarding the emotional aspect of well-being. Emotional well-being (EWB) is a recently developed concept that seeks to understand the contribution of emotions to one’s well-being. Interactive approaches for such investigations are recommended to understand people’s contextual experiences. In this study, we use a qualitative approach to examine the psychological impact of the built environment on its residents to formulate the desiderata for an ideal place based on their perceptions. We use personal construct theory and the associated qualitative repertory grid technique. We recruited 15 students from the United Arab Emirates University and obtained information on their perceptions of three built environments they experienced. The findings revealed information on the students’ emotional constructs that were associated with a set of design-related factors, and the way the ideal hostel should be characterized in response to these associations. These findings enrich our knowledge of EWB within built environments and can inform their future design by considering the emotional aspect of the well-being of residents.

This study investigates how digital alchemy can enhance literature and language teaching through a combination of online and face-to-face learning. It uses constructivist learning theory and the SAMR model to examine how digital tools and resources can transform learner engagement, critical thinking, and creativity. The study gathered data from interviews, focus groups, and document analysis with 30 participants from private HEI schools. The results show that digital alchemy through blended learning allows learners to personalize and collaborate in their exploration of various literary texts. However, the study also identifies some challenges related to resource availability and educator training. The study emphasizes the importance of using digital alchemy in literature and language teaching and suggests some ways for educators, administrators, and policymakers to effectively use digital tools and resources for student-centered teaching methods in the digital era.

The present short communication aimed to determine the effects of vegetable cultivation on health. We conducted a qualitative study using responses to an open-ended question that was part of a survey on regional differences on vegetable intake. Participants in this study were residents of Gunma Prefecture, Japan, and were aged between 20–74 years. In the questionnaire, we asked: “Aside from increasing vegetable intake, how does vegetable cultivation affect your health?” We were able to categorize the answers into six subcategories related to physical health, mental health, and social well-being.

To ensure sustainable production and consumption in the agricultural sector, it is necessary to assess the contribution of each element of the nexus in the agricultural production chain. The aim of this study is to make a quantitative and qualitative analysis of the contributions of each element of the energy, water, waste and land nexus to agricultural products. A composite method approach combining aspects based on input-output model, Location Quotient (LQ) as well as competitive position is adopted. A database of nexus elements over a period from 2009 to 2018 is used for Cameroon, with ten regions considered. The results show proportions of around 0.42% energy, 67.88% water withdrawal, 11.91% harvested area, 97.81% waste for agricultural products. The geolocation of harvested areas shows that the largest portion is in the far north (1,373,829 ha) and the smallest in Adamawa (224,038 ha). Maximum production is in the central region (4,334,095 tons) and minimum in the Adamawa region (915,841 tons). The central, littoral and west regions are more representative of agricultural products. The analysis of the competitive position of agricultural products contributes to a better orientation of national strategies for agricultural sustainability according to existing potentials.

Since large articulated vehicles have uncertainties in trailer articulation angle as well as dynamic complexity, it is not easy to accurately establish a reliable motion plan. In this paper, two geometric path plans constructed based on the empirical rules of driving experts are presented so that articulated vehicles can automatically perform perpendicular parking on a reverse path. By analyzing the empirical parking methods of professional drivers, these path plans were constructed by appropriately combining several standardized simple basic motions to facilitate implementation in real vehicles. In addition, path plans included appropriate complementary motions to effectively respond to uncertainties arising from articulation angles, etc. The complementary motions developed in this study are based on the results of qualitative analysis on the behavior of articulated vehicles. The usefulness of the proposed articulated vehicle parking method has been proven through hundreds of experimental tests using a 1:10 ratio model automated vehicle.

Few studies have examined the pros and cons of integrated TB and HIV service delivery in public healthcare facilities, and even fewer have proposed conceptual models for improved integration. This study intends to fill that vacuum by outlining the development of a facility-based paradigm for integrating TB, HIV and patients services. The design of the proposed model were in stages that involved the evaluation of existing TB-HIV integration model and synthesis of both quantitative and qualitative data from the study sites which were selected public healthcare facilities at both rural and peri-urban settings in Oliver Reginald (O.R) Tambo District Municipality in Eastern Cape, South Africa. Secondary data on 2009-2013 TB-HIV clinical outcomes were obtained from multiple sources for quantitative analysis. Qualitative data involved focus group discussions among patient and heath care staff, which was thematically analysed. The development of a possibly better model and validation of this model show that the district's health system was reinforced by the model's guiding principles, which placed a strong emphasis on inputs, processes, outcomes, and integration effects.The model is adaptable to different healthcare delivery systems but will require support from healthcare stakeholders and professionals to be successful.

Background: Idiopathic normal pressure hydrocephalus is a syndrome with neuroradiological findings and clinical pattern characteristic but not specific for the pathology. Since the prevalence is growing due to the rapidly aging society, standardized and validated protocol for diagnosis is needed, also because this condition may mimic other disorders among elderly such as Parkinson's and Alzheimer's disease. Material and methods: We analysed data from 44 patients with suspect diagnosis of idiopathic normal pressure hydrocephalus with age > 60 years, clinical triad and neuroradiological pattern examined in our ward from November 2018 to November 2022. Neu-ropsychological assessment includes Mini Mental State Examination and Mental Deterioration Battery. Motor scores were collected from gait and balance tests. The evaluation was performed before and after an extended lumbar drainage last 48h. Patients who has scores improvement after the extended lumbar drainage, undergo ventriculoperitoneal shunt with a programmable valve. Results: All patients undergo neuropsychological assessment and motor tests, only 2 patients were unable to perform motor tests because bedridden. 16 patients showed no benefit from the tests, in 2 cases even a worsening of cognitive performance. 28 patients showed an improvement in their performances, but in most cases the improvement involved only the neuropsychological as-sessment. All patients underwent ventriculoperitoneal shunt have had a typical answers pattern in Mental Deterioration Battery test. We performed 9 ventriculoperitoneal shunt and 1 ventricu-lo-atrial shunt. Conclusions: Qualitative neurocognitive tests come out to be more sensitive compared to quantitative neurocognitive tests in identifying patients with suspected idiopathic normal pressure hydrocephalus benefiting from extended lumbar drainage test and then un-derwent surgical treatment. This could be considered a valid screening in elderly patients with suspected idiopathic normal pressure hydrocephalus in order to minimize the number of invasive procedures. More studies are necessary to validate this tool.

Young people living with perinatal infections of Human Immunodeficiency Virus (YLPHIV) face a chronic disease, with treatment including adherence to life-long antiretroviral treatment (ART). The aim of this QES was to explore adherence to ART for YLPHIV as an assemblage within the framework of the BPS model with a new materialist perspective. We searched up to November 2021 and followed the ENTREQ and Cochrane guidelines for QES. All screening, data extraction and critical appraisal was done in duplicate. We analysed and interpreted the findings innovatively, by creating images of meaning, a storyboard, and storylines. We then reported the findings in a narrative first person story. We included 47 studies and identified 9 storylines. We found that treatment adherence has less to do with humans’ preferences, motivations, needs and dispositions, and more to do with how bodies, viruses, things, ideas, institutions, environments, social processes, and social structures assemble. This QES highlights that adherence to ART for YLPHIV is a multisensorial experience in a multi agentic world. Future research into rethinking the linear and casual inferences we are accustomed too in evidence-based health care is needed if we are to adopt multidisciplinary approaches to address pressing issues such as adherence to ART.

Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semi-structured interviews. The inclusion criteria were : suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach. Results: The diagnosis of Lyme disease was primarily triggered by identification with personal testimonies found on the internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients’ etiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

The Performance Assessment for California Teachers (PACT) is a high stakes summative assessment that was designed to measure pre-service teacher readiness. We examined the inter-rater reliability (IRR) of trained PACT evaluators who rated 19 candidates. As measured by Cohen’s weighted kappa, the overall IRR estimate was .17 (poor strength of agreement). IRR estimates ranged from -.29 (worse than expected by chance) to .54 (moderate strength of agreement); all were below the standard of .70 for consensus agreement. Follow up interviews of 10 evaluators revealed possible reasons we observed low IRR, such as departures from established PACT scoring protocol, and lack of, or inconsistent, use of a scoring aid document. Evaluators reported difficulties scoring the materials that candidates submitted, particularly the use of Academic Language. Cognitive Task Analysis (CTA) is suggested as a method to improve IRR in the PACT and other teacher performance assessments such as the edTPA.

Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands –e.g work overload, time pressure, physical burden...-, lack of enough resources and little control –derived from role conflict, unexpected events...- were the most important factors explaining HHs’ stress. Additionally, this imbalance was perceived as leading to health problems –mainly musculoskeletal disorders-. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict –preventing them from enjoying leisure time-. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Violence against paramedics is increasingly recognized as an important occupational health problem, but pervasive and institutionalized underreporting hinders efforts at risk mitigation. Earlier research has shown that the organizational culture within paramedicine may contribute to underreporting and researchers have recommended involving paramedics in the development of violence prevention policies, including reporting systems. Eighteen months after the launch of a new comprehensive violence reporting system in Peel Region, Ontario, Canada, we surveyed paramedics about their willingness to report violent encounters. A total of 204 (33% of eligible) paramedics chose to participate, of whom 67% (N=137) had experienced violence since the launch of the new reporting process, with 83% (N=114) reporting the incidents at least some of the time. In choosing to report, participants cited the accessibility of the new reporting process and the desire to promote accountability among perpetrators while contributing to a safer workplace as motivating factors. Their decisions to file a report, however, could be influenced by the perceived ‘volitionality’ and severity of the violent encounters, particularly in the context of (un)supportive co-workers and supervisors. Ultimately, the participants’ belief that the report would lead to meaningful change within the service was a key driver of reporting behavior.

Blood gas analysis plays a central role in modern medicine. Advances in technology have expanded the range of available parameters and increased the complexity of their interpretation. By applying user-centered design principles, it is possible to reduce the cognitive load associated with interpreting blood gas analysis. In this international, multicenter study, we explored anesthesiologists' perspectives on Visual Blood, a novel visualization technique for presenting blood gas analysis results. We conducted interviews with participants following two computer-based simulation studies: the first utilizing Virtual Reality (VR) (50 participants) and the second without VR (70 participants). Employing the template approach, we identified key themes in the interview responses and formulated six statements, which were rated using Likert scales: from 1 (strongly disagree) to 5 (strongly agree) in an online questionnaire. The most frequently mentioned theme was the positive usability features of Visual Blood. The online survey revealed that participants found Visual Blood to be an intuitive method for interpreting blood gas analysis (median 4, IQR 4-4, p<0.001). Participants noted that minimal training was required to effectively learn how to interpret Visual Blood (median 4, IQR 4-4, p<0.001). However, adjustments are necessary to reduce visual overload (median 4, IQR 2-4, p<0.001). Overall, Visual Blood received a favorable response. The strengths and weaknesses derived from these data will help optimize future versions of Visual Blood to improve the presentation of blood gas analysis results.

Based on a reflection on the tensions between play, education, and learning in early childhood, this article aims to identify and analyze the factors that limit or negatively condition the possibilities for play at school during the transition between Early Childhood Education and Primary Education in Chile. The study was conducted in four Chilean schools, with the Transition Levels of Chilean Early Childhood Education (children aged 4 and 5) and the first two levels of Primary Education (children aged 6 and 7). Based on an ethnographic approach, we combined 22 ethnographic observation days spread over two consecutive years and 59 interviews of various types with children, educators, and parents. The results show structural-material limitations on school play that mainly affect children in Primary Education. Beyond, factors associated with routines, indications, and statements governing functioning and participation in this level tend to limit or prevent play, often considered a "non-legitimate" activity. Conclusions highlight the potentialities that children's restricted or resisted play can present in terms of learning.

The cultivation of berry crops by the type of "intensive plantings" is an economic and scientific approach in modern horticulture. The principles of forming a red currant assortment adapted to mechanized harvesting are considered. The bush should be compact for mechanized harvesting and have a straight-growing or slightly spreading shape. The morphological structure of the bush is a feature determined by the genotype. The ripening period of berries and the mechanical parameters of berries assess the effectiveness of the berry harvesting process. With the help of agrotechnical techniques, the mechanical parameters of berries cannot be improved and are de-termined by weather, soil, water, and climatic factors. The present study was conducted in the 2021-2022 season using 14 red currant genotypes of different geographical and genetic origins to assess cultivars' suitability for machine harvesting. In most of the studied cultivars, berry quality indicators, the parameters of separation force (Fs) and crushing force (Fc) decreased by the time of biological maturity of the genotype. Several cultivars have shown a non-simultaneous decrease in Fs and Fc. A minor limiting feature determines the duration of harvesting. The high correlation of Fs and Fc (R=0.75-0.85) allows us to predict the most significant period for the high-quality operation of a mechanized harvester. There was no dependence of the strength of the attachment of berries to the peduncle on the thickness of the skin of the berries. Jonkheer Van Tets, Red Lake, Rovada, Rolan, Vika, Asya, and Niva can be attributed to technological cultivars as sources of compact and erect bush habit, Jonkheer Van Tets, Rovada, Rolan, Vika, and Asya are recommended for mechanized harvesting.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

Abstract Universities have the potential, and the responsibility, to take on more ecological and relational approaches to facilitating learning-based change in times of interconnected socio-ecological crises. Signs for a transition towards these more regenerative approaches of higher education (RHE) that include more place-based, ecological, and relational, ways of educating can already be found in niches across Europe (see for example the proliferation of education-based living labs, field labs, challenge labs). In this paper, the results of a podcast-based inquiry into the design practices and barriers of enacting such forms of RHE are shown. This study revealed seven educational practices that occurred across the innovation niches. It is important to note these practices are enacted in different ways, or are locally nested in unique expressions, For example, while the ‘practice’ of Cultivating Personal Transformations was represented across the included cases, the way these transformations were cultivated were unique expressions of each context. These RHE-design practices are derived from twenty-six narrative-based podcasts as interviews recorded in the April through June 2021 period. The resulting podcast (The Regenerative Education Podcast) was published on all major streaming platforms from October 2021 and included 21 participants active in Dutch Universities, 1 in Sweden, 1 in Germany, 1 in France, and 3 primarily online. Each episode engages with a leading practitioner, professor, teacher, and/or activist that is trying to connect their educational practice to making the world a more equitable, sustainable, and regenerative place. The episodes ranged from 30 to 70 minutes in total length and included both English (14) and Dutch (12) interviews. These episodes were analyzed through transition mapping a method based on story analysis and transition design. The results include seven design practices such as Cultivating Personal Transformations, Nurturing Ecosystems of Support, and Tackling Relevant and Urgent Transition Challenges, as well as a preliminary design tool that educational teams can use together with students and local agents in (re)designing their own RHE to connect their educational praxis with transition challenges.

The literature on substance use usually extracts conclusions from data with correlational methods. Our study shows the usefulness of complementing ordered logistic regression (OLR) and fuzzy set qualitative comparative analysis (fsQCA) to assess factors inducing cannabis consumption in a sample of 1,935 teenagers. OLR showed a significant influence of gender (odd ratio (OR) =0.383, p<0.0001), parental monitoring (OR=0.587, p=0.0201); religiousness (OR=0.476, p=0.006); parental tolerance to substance use (OR=42.01, p<0.0001) and having close peers that consume substances (OR=5.60, p<0.0001). FsQCA has allowed fitting linkages between factors from a complementary perspective. (1) Coverage (cov) and consistency (cons) attained by solutions explaining use (cons=0.808, cov=0.357) are clearly lower than by recipes of non-use (cons=0.952, cov=0.869) (2) The interaction of gender, a tolerant family to use and the attitude toward substances by peers is very consistent to explain cannabis use. (3) The most important recipe explaining resistance to cannabis is simply parental disagreement with substance consumption (cons=0.956, cov=0.861) (4) Factors as gender, religiosity, parental monitoring and age show also a relevant impact on attitude toward cannabis use. However, whereas some of them impact symmetrically on use and non-use this does not follow in factors such as parental monitoring or age.

Discrete, logic-based models are increasingly used to describe biological mechanisms. Initially introduced to study gene regulation, these models evolved to cover various molecular mechanisms, such as signalling, transcription factor cooperativity, and even metabolic processes. The abstract nature and amenability of discrete models to robust mathematical analyses make them appropriate for addressing a wide range of complex biological problems. Recent technological breakthroughs have generated a wealth of high throughput data. Novel, literature-based representations of biological processes and emerging algorithms offer new opportunities for model construction. Here, we review up-to-date efforts to address challenging biological questions by incorporating omic data into logic-based models, and discuss critical difficulties in constructing and analysing integrative, large-scale, logic-based models of biological mechanisms.

We aimed to explore university students’ perceptions and experiences of SARS-CoV-2 mass asymptomatic testing, social distancing and self-isolation during the COVID-19 pandemic. This qualitative study comprised of four rapid online focus groups conducted at a higher education institution in England during high alert (tier 2) national COVID-19 restrictions. Data were analysed thematically. Participants were purposively sampled university students (n = 25) representing a range of gender, age, living circumstances (on/off campus) and SARS-CoV-2 testing/self-isolation experiences. Six themes with 16 sub-themes emerged from the analysis of the qualitative data: ‘Term-time Experiences’, ‘Risk Perception and Worry’, ‘Engagement in Protective Behaviours’, ‘Openness to Testing’, ‘Barriers to Testing’ and ‘General Wellbeing’. Students described feeling safe on campus, believed most of their peers are adherent to protective behaviours and were positive towards asymptomatic testing in university settings. University communications about COVID-19 testing and social behaviours need to be timely and presented in a more inclusive way to reach groups of students who currently feel marginalised. Barriers to engagement with SARS-CoV-2 testing, social distancing and self-isolation were primarily associated with fear of the mental health impacts of self-isolation, including worry about how they will cope, high anxiety, low mood, guilt relating to impact on others and loneliness. Loneliness in students could be mitigated through increased intra-university communications and a focus on establishment of low COVID-risk social activities to help students build and enhance their social support networks. These findings are particularly pertinent in the context of mass asymptomatic testing programmes being implemented in educational settings and high numbers of students being required to self-isolate. Universities need to determine the support needs of students during self-isolation and prepare for the long-term impacts of the pandemic on student mental health and welfare support services.

Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and three group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analysed using thematic analysis. Two overarching themes were identified. These were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice respectively: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients); and balancing expectations and pre-conceptions of self-management (providers). Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients were in need of support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers with respect to communication and uptake of self-management advice.

Background: Since 2000, vaccine coverage in Sub-Saharan Africa (SSA) has surpassed multiple milestones. Its contribution to global health, especially in low-middle-income countries is one of the achievements in global governance of modern medicine, averting 2-3 million child deaths every year. However, in Nigeria, vaccine-preventable-diseases still account for one in eight child deaths before their fifth-year birthday and remains one of the ten countries where 4.3 million children under five are without complete immunization. The reasons for declining childhood vaccine demand are unclear. Therefore, the goal of this contribution is to shed light on the reasons to set a foundation for future interventions. Methods: Four focus group discussions were conducted. The primary targets were mothers of children 0 – 12 months old in Nigeria. A simplified quota sampling approach was used to select mothers in four geographical clusters of Nigeria’s Federal Capital Territory. At least six mothers from each cluster were randomly included, giving a total of 24 participants. An interview guide developed from the 5C psychological antecedence model was used (assessing confidence, complacency, calculation, constraints, collective responsibility); two additional variables were included that had proved meaningful in previous work (religion and masculinity). The data were analyzed using meta-aggregation approach such as framework synthesis, which summarized data in a stepwise fashion. Results: The sample was generally relatively positive towards vaccination. Still, mothers reported low trust in vaccine safety and the healthcare system (confidence). Yet, they had great interest in seeking additional information during antenatal visits (calculation), difficulties in prioritizing vaccination over other equally competing priorities (constraints) and were aware that vaccination translates into overall community health and wellbeing (collective responsibility). They had a bias towards God as ultimate giver of good health (religion) and reported that their husbands played a dominant role in vaccination decision-making (masculinity). Mothers perceived their children vulnerable to disease outbreaks, which motivated them to get them vaccinated (complacency). Conclusion: The 5C model and the added determinants provided a useful qualitative tool for understanding mothers’ vaccination decision-making in low resources settings.

Enhanced food and nutrition security remains a primary goal for every community. Several interventions have been promoted in dry areas to improve issues on food and nutrition security. However, studies on the level of knowledge, cultural norms, perceptions and attitudes that are key drivers in adoption and uptake to highlight gaps and provide evidence for improvement are limited. This study investigated variables influencing the adoption and implementation of an integrated crop-dairy goat farming system in Elgeyo Marakwet. A descriptive cross-sectional survey entailing qualitative and quantitative approaches among farmers practicing integrated farming was undertaken. A thematic questionnaire was used to collect quantitative data, while key informant interviews and focus groups discussions were used in qualitative research. This study utilized the multi-stage sampling procedure to sample the farmers and sample size was calculated based on Krejcie and Morgan table. Data analysis for quantitative data was done using SPSS software while qualitative data utilized N-vivo software The findings show that farmers have knowledge on the integrated farming system. Age, level of education, land size, gender, perceptions and attitudes influence adoption. Small animals like dairy goats are associated to women in this community hence increasing their participation in access, control and decision making of agricultural resources. The key findings of this study provide baseline data that can form evidence to help inform policy on the indicators contributing to adoption of integrated crop-dairy goat systems to enhance food and nutrition security

Role identity theory describes the purpose and meaning in life that comes, in part, from occupying social roles. While robustly linked to health and well-being, this may become, however, when an individual is unable to fulfil the perceived requirements of an especially salient role in the way that they believe they should. Amid high rates of mental illness among public safety personnel, we interviewed a purposely selected sample of 21 paramedics from a single service in Ontario, Canada to explore incongruence between an espoused and able-to-enact paramedic role identity. Situated in an interpretivist epistemology, and using successive rounds of thematic analysis, we developed a framework for role identity dissonance wherein chronic, identity-relevant disruptive events cause emotional and psychological distress. While some participants were able to recalibrate their sense of self and understanding of the role, for others, this dissonance was irreconcilable, contributing to disability and lost time from work. In addition to contributing a novel perspective on paramedic mental health and well-being, our work also offers a modest contribution to the theory in using the paramedic context as an example to consider identity disruption through chronic workplace stress.

This research paper aimed to explore the impact of childhood and adolescent experiences on the leadership development of Emirati women in the United Arab Emirates (UAE). Using a qualitative research methodology, the study utilized in-depth narrative semi-structured interviews, document analysis, and diary writing to understand the complex issue of leadership development. Findings indicate that childhood and adolescent experiences, including family upbringing, education, culture, and societal expectations, have significant impacts on the leadership development of Emirati women. Specifically, family upbringing and cultural values shape Emirati women's leadership aspirations and behaviors, while education and societal expectations provide opportunities and barriers for women's leadership development. The implications of these findings for policymakers and practitioners seeking to promote women's leadership development in the UAE are discussed.

Women have been leading organizations and communities for centuries, but their journeys in leadership have sometimes been challenging. This paper aims to reflect on women's positive and negative experiences in leadership roles and understand the factors contributing to their successes and challenges.To explore these issues, we will draw on various academic literature, including studies on gender and leadership and case studies of women in leadership positions. We will also examine the cultural and social factors that affect women's experiences in leadership, including bias and discrimination, societal expectations, and work-life balance challenges.One key theme from this analysis is the importance of role models and support networks in helping women succeed in leadership roles. Women with access to mentorship, sponsorship, and peer networks are more likely to thrive in their roles and overcome the challenges they may face. However, lacking female role models and mentors can make it difficult for women to advance in their careers and contribute to feelings of isolation and imposter syndrome.Another important theme is the need for organizations and society to address systemic biases and discrimination that prevent women from reaching their full potential. This can include initiatives such as unconscious bias training, flexible work arrangements, and policies that support gender diversity and inclusion.In conclusion, this paper highlights women's positive and negative experiences in leadership roles and emphasizes the need for ongoing efforts to support and empower women in leadership. By addressing the challenges women face and building a culture of inclusion and support, organizations and society can help unlock the full potential of women leaders and create a more equitable and just world.