Context-specific Issues Research Articles

Management of Sepsis in Emergency Departments in Saudi Arabia: A Systematic Review

Objectives: To assess the management of sepsis in the emergency departments (EDs) in Saudi Arabia. Methods: A total of 388 pertinent publications were found after a comprehensive search across four databases. 47 full-text publications were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; four studies finally satisfied the requirements for inclusion. Results: We included four studies involving a total of 1795 sepsis patients, and 716 (39.8%) were males. On time, antibiotic administration is very important in the management of sepsis. Most of the patients were treated within the first hour, though mortality differences between early and immediate antibiotic groups did not reach significance. Imaging and microbiological diagnosis is essential, especially for high-risk groups like infants; empirical therapy was often initiated by clinical presentations. Delays in administering antibiotics during handovers did not significantly impact mortality and diagnostic outcomes. Early detection tools and tailored protocols, including local resistance patterns, showed promise in improving the care of sepsis patients by using structured strategies that take into account specific contextual issues. Conclusion: This review highlights the importance of timely antibiotics, comprehensive diagnostics, and tailored protocols in sepsis management in Saudi Arabia's emergency departments. While adherence to international guidelines is evident, local bacterial resistance patterns, diagnostic precision, and operational efficiency remain critical for optimizing outcomes. Future research should focus on larger, prospective studies with standardized metrics to enhance long-term effectiveness and improve care quality for sepsis patients in the region.

Teachers’ Motivations, Challenges and Difficulties in Action Research: A Narrative Study

Action research is a powerful tool for teachers to engage in reflective practice and drive educational improvement in addressing context-specific issues within schools. While action has been widely recognized as a valuable tool for improving teaching practices, there remains a limited understanding of the specific motivations, challenges, and difficulties teachers face in conducting action research, particularly in the context of public schools in the Philippines. Existing studies often focus on quantitative data, leaving a gap in narrative-driven, teacher-centered insights. This study explored the motivations, challenges, and difficulties of teachers at Isulan National High School (INHS) face when conducting action research. A narrative research design was employed to capture in-depth responses, with data collected through semistructured interviews. Five teachers were selected using purposive sampling to represent various positions, including Teacher I to Master Teacher II. Thematic analysis revealed that teachers are primarily motivated by a desire for positive change, real-world engagement, skill enhancement and personal growth, collaboration, and adaptability in addressing educational challenges and improving pedagogical practices. However, significant challenges hinder their ability to conduct action research effectively. These include time constraints due to heavy workloads, resistance to change from colleagues and administrators, sustainability issues in implementing research findings, negative perceptions and attitudes toward research activities, and a lack of conceptual knowledge about research methodologies. Despite these barriers, participants believed that action research is vital for professional development. It provides opportunities for skill enhancement, critical reflection, self-improvement, and exploration of innovative strategies to impact teaching and learning positively. Furthermore, the study recommends the need for targeted professional development programs, improved resource allocation, and the establishment of a supportive research culture. These measures are essential to ensure the sustainability and effectiveness of action research in enhancing educational practices at INHS.

Maternal and newborn health prioritization in Yobe State, Nigeria: analysis of stakeholders' perspective.

Maternal and newborn mortality and morbidity in conflict-affected northeastern areas of Nigeria, such as Yobe State, are disproportionately higher than those in the rest of the country. There is limited evidence on the factors that influence maternal and newborn health (MNH) policymaking and implementation in this region, particularly with respect to the impact of conflict and context-specific issues. This study explores the political, economic and health system factors that drive the prioritization of MNH policies in Yobe State. The aim of this study was to elucidate the conflict-related factors influencing MNH outcomes, which could inform targeted interventions to improve MNH. The study is a descriptive case study that relies on multiple data sources and is guided by the Health Policy Analysis Triangle. We reviewed national and subnational research, technical reports and policies related to reproductive health and the MNH in Nigeria since 2010. Following stakeholder mapping, we identified and invited prospective participants in the MNH policymaking space. Nineteen stakeholders from the government, civil society and nongovernmental organizations, donor agencies, and public and private sector health providers in Yobe State participated in the semistructured in-depth interviews. Data were collected from November 2022 through January 2023 and were thematically analysed via Dedoose software. MNH services in Yobe State have received considerable attention through initiatives such as the National Midwifery Service Scheme, free MNH services, training of midwives with deployment to rural areas, and health facility renovations. The effective implementation of MNH services and policies faces challenges due to insufficient funding, and sustainability is hampered by changes in governance and political transitions. The Boko Haram insurgency exacerbated the humanitarian crisis in Yobe State and disrupted MNH services due to the displacement of populations and the decline in the number of health workers. Additionally, sociocultural and religious beliefs hinder timely access to and utilization of MNH services. Although policies and guidelines for MNH services exist in the state, they are inadequately disseminated to health providers, which affects their effective implementation across facilities. Collaboration and intersectoral coordination platforms exist, but competition and rivalries among unions, political entities, and implementing agencies sometimes impede progress. Enhancing MNH services in Yobe state requires increased commitment for funding through the Northeast Development Commission rehabilitation fund; strengthening the health workforce, safety and retention plan; promoting gender inclusivity within the health sector; and addressing sociocultural barriers to women's health-seeking behaviors. Concrete, time-bound plans for policy dissemination are necessary to ensure effective service implementation.

AI-Powered Semantic Framework for Inclusive Web Accessibility Evaluation

Web accessibility is a critical aspect of inclusive digital experiences, ensuring equitable access for users with diverse abilities. Despite significant advancements, existing automated tools often fail to detect complex and context-specific accessibility issues. This research proposes an AI-powered semantic framework for comprehensive web accessibility evaluation, leveraging artificial intelligence to analyze and interpret web content with a focus on inclusivity and compliance with accessibility standards. The framework integrates semantic analysis to identify nuanced accessibility barriers, such as inadequate alt text, improper heading structures, and color contrast violations, which are often missed by traditional tools. By utilizing machine learning and natural language processing, the proposed solution aims to bridge gaps in guideline interpretation and enhance the detection of user experience challenges. Additionally, this research incorporates user feedback mechanisms and expert insights to continuously refine the framework, making it adaptable to evolving accessibility needs. Extensive testing across diverse web environments demonstrates the framework's ability to improve detection accuracy, reduce evaluation times, and provide actionable insights to developers. The proposed framework not only advances automated accessibility evaluation but also contributes to fostering a more inclusive internet by empowering developers and organizations to proactively address accessibility barriers.

The sustainability of developmental programs by the U.S. and China in Sub-Saharan Africa: a comparison of effectiveness

This descriptive comparative qualitative case study examines the sustainability of development programs in Sub-Saharan Africa. We evaluated economic, social, environmental, and institutional development programs from the People’s Republic of China (PRC) and the U.S. to Sub-Saharan Africa for sustainable development to fill the research gap on these technique’s success and effects on Sub-Saharan Africa. Using purposive sampling, we chose eight Sub-Saharan African countries representing distinct geographies and economies. The College of William & Mary’s AID Data-GeoCoded Chinese Official Finance Dataset, China Africa Research Initiative, and USAID’s Foreign Aid Explorer provided data. Results revealed a complex view of Sub-Saharan Africa’s development policy success. Proposition 1, which claims China’s economic tactics exceed those of the U.S., is supported by significant infrastructure investments but presents sustainability problems. Proposition 2, praising the social development initiatives of the U.S., is supported by gains in healthcare and education in other countries. However, context-specific issues persist. Proposition 3 shows that U.S. conservation collaborations have improved environmental preservation. Proposition 4 claims that both countries’ institutional development plans fail. The results highlight local government buy-in issues and the need for adaptation. Some of the ideas find support in recent research; however, country and context differences require unique tactics. Development efforts in Sub-Saharan Africa should focus on long-term sustainability, local objectives, and environmental implications. Effective institutional growth requires adaptation and a strong awareness of local governing dynamics, and policymakers, development practitioners, and scholars may gain insight into sustainability and development projects in Sub-Saharan Africa from this research. A holistic approach that balances economic, social, environmental, and institutional factors is needed to attain sustainable development goals.

A transformer-driven framework for multi-label behavioral health classification in police narratives

<p>Transformer-based models have shown to be highly effective for dealing with complex tasks in a wide range of areas due to their robust and flexible architecture. However, their generic nature frequently limits their effectiveness for domain-specific tasks unless significantly fine-tuned. We understand that behavioral health plays a vital role in individual well-being and community safety, as it influences interpersonal interactions and can significantly impact public safety. As a result, identifying and classifying these cases demands the use of an effective tool, such as a framework, that has been fine-tuned to context-specific behavioral health issues. In this work, we demonstrated a trainable lightweight approach for addressing behavioral health analysis utilizing feature embeddings generated from transformer-based models. To facilitate in domain adaptation, we created instruction sets based on annotations by subject matter experts, enabling for targeted fine-tuning of the large language model (LLM) for behavioral health applications. Our experiments demonstrated that parameter-frozen transformer-based models can capture high-quality feature representations that allowed for the integration of a lightweight framework, making them especially useful in resource-constrained settings.</p>

The Cultural Role of Civil Societies and the National Parliament in the Domestic Enforcement of International Laws on Corruption in Tanzania

Social structures composed of active and responsible actors can be essential in curbing corruption. However, studies focusing on culture and corruption, especially in Africa, are scant. This article has focused on the role of culture in influencing anti-corruption efforts and enforcing international law on corruption in Tanzania. Using ethnography, the paper responds to two questions: What is the cultural role of civil societies and the media in influencing the domestic enforcement of international law? Furthermore, what is the cultural role of the Tanzanian legislature in influencing the domestic enforcement of international law? A cultural study can only be conducted after some time. It calls for a longitudinal study that considers a local context. In this regard, a case study research design has been used. The technique can explore issues over a long period and examine context-specific issues. Overall, the study's findings highlight the development of a unique culture among civil societies, which prompts the Parliament to create and formalize anti-corruption measures. The paper adds to international law, corruption, and culture scholarship

Developing an integrated participatory methodology framework for campus sustainability assessment tools (CSAT): A case study of a sino-foreign university in China

The issue of sustainable development is a topic that needs to be studied, analysed, and addressed by higher education institutions. Campus sustainability assessment tools (CSATs) are commonly adopted internationally to evaluate and improve measures utilised for the development outcomes of universities. Whilst some Chinese universities have taken positive steps towards attaining sustainability in their operations, teaching and/or research, and China has come up with its own evaluation criteria for green universities, majority of their approach still have shortcomings, such as lack of multiple stakeholder involvement and a one size fits all approach to campus sustainability strategy. Thus, the aim of this paper is to investigate two core methodological issues (top-down and non-transparent approaches and the limited consideration of context-specific issues) that impact the efficacy of CSATs in order to optimize the selection process for indicators and enhance the development CSAT for Chinese campuses and other campuses globally. Based on the widely used assessment tools (both campus and neighbourhood) in foreign countries, 147 corresponding assessment indicators in 16 domains were collated through qualitative review of existing assessment tools and the questionnaire-based analysis through the analytic hierarchy process (AHP). The case study campus selected was the University of Nottingham Ningbo China. The indicators to be investigated were selected based on frequency and distributed in the form of a questionnaire to the staff and students after a comprehensive stakeholder survey analysis. The staff and students were used to illustrate the high interest and high influence dynamic versus the high interest and low influence dynamic. This research was conducted to gain insight towards developing an integrated, inclusive, and context relevant CSAT. Furthermore, a new framework was developed for Chinese Campus sustainable assessment planning, using the University of Nottingham Ningbo as Case study. This framework provides step by step phases for CSAT development that includes the database phase, minimization phase, stakeholder phase and integration and implementation phase. Within these phases, factors that determined the success and failure were discussed such as issues of acceptability versus pragmatism, willingness of stakeholders to participate, weighing of indicators, stakeholder analysis and redistribution of power for the less influential. This led to the sample selection of indicators, which serve as validation of impact of this integrated methodological process. The final recommendation given is that all regions should create and provide avenues for tailored processes for the selection, weighting and criteria development of sustainability indicators and assessment tools. This needs to promote inclusivity, transparency and contextual relevance in decision making, which should be the main considerations for any truly sustainable framework. In addition, as a final measure to ensure methods such as CSATs are implemented in wider China and globally, this study identified the need for coordination, support, and participation of competent and sustainability driven leaders, government parastatals (National and provincial level), pilot demonstration, as well as data transparency throughout related campus departments.

Personal Cognition and Implicit Constructs Affecting Preferential Decisions on Farmland Ownership: Multiple Case Studies in Kediri, East Java, Indonesia

Farmland ownership is a critical issue for sustainable agriculture since it affects short-term productivity and the long-term stability of the sector. However, existing literature largely focused on immediately simplifying individual opinions through statistical methods, neglecting how implicit values could drive preferential ownership decisions. Therefore, this study aimed to understand the driving factors underlying decisions on farmland ownership, especially when there are cognitive factors that induce hidden constructs in individual preferences. This research, to observe the cognition and implicit values leading to ownership decisions, applied the Repertory Grid Technique (RGT) with subsequent Principal Component Analysis (PCA). Taking the multiple case studies of three villages in Kediri, East Java, Indonesia, this study involved 40 farmland owners. The RGT revealed a staggering 85 constructs leading to six ownership decisions: keep farming, buying, joint farming, leasing, selling, and converting. In general, the driving forces were distinguished into landowners’ household profile, sustainability-related (community and social conditions), spatial (farmland conversion and accessibility), and economic aspects. Based on PCA, “buying” and “keep farming” shared several driving forces and led to sustainable farming. In contrast, “joint farming”, “leasing”, “selling”, and “converting” were found to threaten farming sustainability. In addition, this study offers in-depth insights into the driving factors of different preferential ownership decisions according to the cognition and implicit values of individual landowners, allowing policymakers and other stakeholders to tailor policies and strategies to context-specific farmland ownership issues in pursuing sustainable agriculture.

Is theoretical topic-specific research “old fashioned”? An epistemological inquiry about the ontological creativity of Mathematics Education Research

In Mathematics Education (ME), research dealing with topic-specific (TS) issues (e.g., what levels of development exist in learning fractions) produces usually local results and is considered less fashionable and attractive for innovative research projects than research dealing with context-specific (CS) issues that have more general and abstract scopes (e.g., what is mathematical instruction? what is the field of ME?) and produces middle-range or grand theories. TS- and CS-research run along separate tracks with little or no crossover, at least from the beginning of the socio-political-turn in ME, but connecting them could help to single out hidden variables in CS-research. This paper shows that TS-research creates specific mathematical objects that allow us to reduce the distance between these two lines of research. Mathematical objects specific to ME research are shown to be both a technical link between the two lines of research because they allow topic-specificity to access more abstract and general realms of research, as well as factor at stake when aspects related to the social, political, and ethical implications of the ontological creativity of TS-research are discussed in a critical postmodern approach. Discussing its impact on textbooks, teacher-training, teaching practices, further TS-research-practices, as well as on the researcher’s epistemological empowerment and on the self-referentiality of ME research, TS-research moves from the periphery to the heart of CS-research.

Assessment of the Influence of Contextual Issues in Evaluating eHealth Systems Usability in Tanzania

The adoption of eHealth systems in healthcare facilities has rapidly increased in many countries. However, the main challenge has been the quality and level of usability of those adopted systems, and the complexity of the challenge varies from one country to another based on contextual issues. Usability is also linked to contextual issues, which have a direct impact on deciding the methods for providing services on similar systems. This research focuses on assessing the influence of contextual issues on metrics that are applicable for evaluating the usability of eHealth systems through a case study of Tanzania. The findings of this research were obtained through the quantitative method, and the analysis was performed through structural equation modelling (SEM) using AMOS and SPSS applications. It is evident from this research that contextual factors, such as user characteristics, goals and tasks, technical environment, physical environment, and resources and technology, significantly impact the usability metrics that are important to the evaluation of eHealth systems. The usability metrics for eHealth systems identified in this research include navigation visibility, accessibility, perceived ease of use, error correction, internal collaboration, information quality, external collaboration, technical quality, guide and support, and perceived benefits. This study also revealed that the usability evaluation of eHealth systems should consider both common metrics and specific metrics in order to uncover both general information system and health context-specific usability issues

Strengthening Speed and Child Restraint Enforcement Capacity in the Philippines

Recent legislative developments in the Philippines provided opportunities to strengthen existing speed enforcement capacity and build competence in relation to enforcing child restraint use for the first time in this country. The Global Road Safety Partnership’s (GRSP) Road Policing Capacity Building programme team worked closely with government and non-government agencies in the Philippines to develop and deliver a series of classroom and roadside theoretical and operational training sessions. These training sessions resulted in the establishment of a core group of trainers from within local enforcement agencies in the country. This group received initial training as well as ongoing coaching and mentoring support from GRSP to establish a sustainable model of enforcement capability development. Various training methods and curriculum topics are described, noting the importance of supporting in-country partners to determine relevant, context-specific issues according to local needs in the country. This body of work provides a useful example of mechanisms to transfer specific knowledge from the field of traffic law enforcement to police officers in a systematic way, and to build training and enforcement capacity in a sustainable manner.

Malaria Burden Stratification in Malawi- A report of a consultative workshop to inform the 2023-2030 Malawi Malaria Strategic Plan.

Background: Malawi's National Malaria Control Programme (NMCP) is developing a new strategic plan for 2023-2030 to combat malaria and recognizes that a blanket approach to malaria interventions is no longer feasible. To inform this new strategy, the NMCP set up a task force comprising 18 members from various sectors, which convened a meeting to stratify the malaria burden in Malawi and recommend interventions for each stratum. Methods: The burden stratification workshop took place from November 29 to December 2, 2022, in Blantyre, Malawi, and collated essential data on malaria burden indicators, such as incidence, prevalence, and mortality. Workshop participants reviewed the malaria burden and intervention coverage data to describe the current status and identified the districts as a appropriate administrative level for stratification and action. Two scenarios were developed for the stratification, based on composites of three variables. Scenario 1 included incidence, prevalence, and under-five all-cause mortality, while Scenario 2 included total malaria cases, prevalence, and under-five all-cause mortality counts. The task force developed four burden strata (highest, high, moderate, and low) for each scenario, resulting in a final list of districts assigned to each stratum. Results: The task force concluded with 10 districts in the highest-burden stratum (Nkhotakota, Salima, Mchinji, Dowa, Ntchisi, Mwanza, Likoma, Lilongwe, Kasungu and Mangochi) 11 districts in the high burden stratum (Chitipa, Rumphi, Nkhata Bay, Dedza, Ntcheu, Neno, Thyolo, Nsanje, Zomba, Mzimba and Mulanje) and seven districts in the moderate burden stratum (Karonga, Chikwawa, Balaka, Machinga, Phalombe, Blantyre, and Chiradzulu). There were no districts in the low-burden stratum. Conclusion: The next steps for the NMCP are to review context-specific issues driving malaria transmission and recommend interventions for each stratum. Overall, this burden stratification workshop provides a critical foundation for developing a successful malaria strategic plan for Malawi.

Beliefs, attitudes and practices towards scabies in central Ghana.

Scabies commonly affects poor populations in low-middle-income countries. The WHO has advocated for country-driven and country-owned control strategies. Knowledge of context specific issues will be important for design and implementation of scabies control interventions. We aimed to assess beliefs, attitudes and practices towards scabies in central Ghana. Data was collected via semi-structured questionnaires for people who had active scabies or scabies in the past year and people who never had scabies in the past. The questionnaire covered several domains: knowledge about the causes and risk factors; perceptions towards stigmatisation and consequences of scabies in daily life; and treatment practices. Out of 128 participants, 67 were in the (former) scabies group and had a mean age of 32.3 ± 15.6 years. Overall scabies group participants less often indicated a factor to predispose to scabies than community controls; only 'family/friends contacts' was more often mentioned in the scabies group. Scabies causation was attributed to poor hygiene, traditional beliefs, heredity and drinking water. Individuals with scabies delay care seeking (median time from symptom onset to visiting the health centre was 21 [14 - 30] days) and this delay is enhanced by their beliefs (like witchcraft and curses) and a perception of limited disease severity. Compared to past scabies participants in the dermatology clinic, participants with past scabies in the community tended to have a longer delay (median [IQR] 30 [14-48.8] vs 14 [9.5-30] days, p = 0.002). Scabies was associated with health consequences, stigma, and loss of productivity. Early diagnosis and effective treatment of scabies can lead to persons less frequently associating scabies with witchcraft and/ or curses. There is the need to enhance health education to promote early care seeking, enhance knowledge of communities on impact and dispel negative perceptions about scabies in Ghana.

Challenges Facing Learners’ Acquisition of Employability Competencies under Competency-Based Education and Training Approach in Vocational Education and Training Centres in Tanzania

The purpose of this article is to investigate the causes of inadequate employability competencies among vocational education and training (VET) graduates using a competency-based education and training (CBET) approach. The article identifies respondents' perspectives on the challenges of acquiring employability competencies during the civil artisans' training and learning process in VETIs under CBET and explores opinions for overcoming those challenges. Data were gathered from 126 respondents through semi-structured interviews with trainers and employers, an open-ended questionnaire for learners, and employee-focused group discussions. A qualitative exploratory approach research design was used. Thematic analysis was used to analyse documents and interview transcripts. The findings revealed that the acquisition of employability competencies is hampered by learner characteristics, insufficient training and learning resources, shortage of trainers, English language problems, training methods, and negative perception of parents and learners on VET programmes, all of which were identified in the conceptual framework and mentioned by all categories of respondents. It is likely that the challenges discovered were not novel, with the exception of a lack of internet and a scarcity of clean water and food, which were context-specific issues. As a result, the study recommends that government and VET stakeholders should ensure the availability of learning resources to enhance effective training and learning at VET. More serious English language instruction should begin in primary school, according to the government and VET stakeholders. VET trainers should improve field supervision exercises and expose trainees to the working environment where employability competencies can be imparted more easily than through classroom training alone. Trainers should also participate in workshops and industrial visits to gain skills and knowledge about labour market needs. This will improve trainers' and trainees' understanding of labour-market requirements.

Good participatory practice for coronavirus disease 2019 (COVID-19) research: the case of a COVID-19 prevention study

Background: The COPCOV study (chloroquine/ hydroxychloroquine prevention of coronavirus disease), which started recruitment in April 2020, is a multi-country double-blind, randomised, placebo-controlled trial which is being conducted in healthcare facilities involved in COVID-19 case management. Participants are staff employed in facilities managing people with proven or suspected COVID-19. As part of the study, we conducted a series of engagement sessions. The aims were to assess the feasibility of the study, to identify context-specific ethical issues, to understand possible concerns, to fine tune research procedures and to refine the COPCOV information materials. Methods: The COPCOV study was approved by relevant institutional review boards. The sessions described in this paper were part of the study. We conducted a series of engagement sessions, each involving a short presentation of the study, a section where attendees were asked to express their willingness to participate in such a study, which information they would need to change their view and an open Q&A section. Answers were transcribed and coded into themes by two independent investigators. Themes were derived from the data. They complemented other site-specific engagement, communication, and public relation activities such as press releases and websites. Results and conclusions: From 16 th March 2020 to 20 th January 2021, 13 engagement sessions were conducted in Thailand, Laos, Vietnam, Nepal and the UK involving 222 attendees in total. Issues raised revolved around the social value and study rationale; safety of trial medications and risk-benefit balance; study design and commitments. These sessions helped us identify concerns people had, which helped us refine information materials as well as complement site feasibility assessments. Our experience strongly supports the use of participatory practices prior to conducting clinical trials.

Unpacking the ‘black box of horrendousness’: a qualitative exploration of the barriers and facilitators to conducting trials involving adults lacking capacity to consent

BackgroundTrials involving adults who lack capacity to consent encounter a range of ethical and methodological challenges, resulting in these populations frequently being excluded from research. Currently, there is little evidence regarding the nature and extent of these challenges, nor strategies to improve the design and conduct of such trials. This qualitative study explored researchers’ and healthcare professionals’ experiences of the barriers and facilitators to conducting trials involving adults lacking capacity to consent.MethodsSemi-structured interviews were conducted remotely with 26 researchers and healthcare professionals with experience in a range of roles, trial populations and settings across the UK. Data were analysed using thematic analysis.ResultsA number of inter-related barriers and facilitators were identified and mapped against key trial processes including during trial design decisions, navigating ethical approval, assessing capacity, identifying and involving alternative decision-makers and when revisiting consent. Three themes were identified: (1) the perceived and actual complexity of trials involving adults lacking capacity, (2) importance of having access to appropriate support and resources and (3) need for building greater knowledge and expertise to support future trials. Barriers to trials included the complexity of the legal frameworks, the role of gatekeepers, a lack of access to expertise and training, and the resource-intensive nature of these trials. The ability to conduct trials was facilitated by having prior experience with these populations, effective communication between research teams, public involvement contributions, and the availability of additional data to inform the trial. Participants also identified a range of context-specific recruitment issues and highlighted the importance of ‘designing in’ flexibility and the use of adaptive strategies which were especially important for trials during the COVID-19 pandemic. Participants identified a need for better training and support.ConclusionsResearchers encountered a number of barriers, including both generic and context or population-specific challenges, which may be reinforced by wider factors such as resource limitations and knowledge deficits. Greater access to expertise and training, and the development of supportive interventions and tailored guidance, is urgently needed in order to build research capacity in this area and facilitate the successful delivery of trials involving this under-served population.

Is urbanisation in the Global South fundamentally different? Comparative global urban analysis for the 21st century

A vigorous debate has emerged in recent years over how to understand cities of the Global South. A pivotal issue in this debate is whether urbanisation processes in the South are so fundamentally different from historical and current urbanisation in the Global North that many of the theories developed from studying the latter have limited utility in application to the former. In this article, we review evidence from a range of disciplines on recent and ongoing urban transitions and urbanisation dynamics in the Global South, attending to features that distinguish the urban South from the urban North. Our reading of the evidence indicates that parts of the Global South may be urbanising along historically and geographically specific trajectories; however, we argue that these differences are best understood through a unified set of global urban theories. Rather than flattening or silencing difference, theories that seek generalisation across time and space sharpen the identification and appreciation of key differences in urbanisation processes. Analysing how the fundamental dynamics of urbanisation recombine and interact with one another in different contexts offers insight into policy challenges that cut across cities, both within and between the Global South and North, as well as context-specific policy issues that arise through the interaction of global urbanisation forces and local specificities.

Ethics, Guidelines, Standards, and Policy: Telemedicine, COVID-19, and Broadening the Ethical Scope.

The coronavirus crisis is causing considerable disruption and anguish. However, the COVID-19 pandemic and consequent explosion of telehealth services also provide an unparalleled opportunity to consider ethical, legal, and social issues (ELSI) beyond immediate needs. Ethicists, informaticians, and others can learn from experience, and evaluate information technology practices and evidence on which to base policy and standards, identify significant values and issues, and revise ethical guidelines. This paper builds on professional organizations' guidelines and ELSI scholarship to develop emerging concerns illuminated by current experience. Four ethical themes characterized previous literature: quality of care and the doctor-patient relationship, access, consent, and privacy. More attention is needed to these and to expanding the scope of ethical analysis to include health information technologies. An applied ethics approach to ELSI would addresses context-specific issues and the relationships between people and technologies, and facilitate effective and ethical institutionalization of telehealth and other health information technologies.

DaQAPO: Supporting flexible and fine-grained event log quality assessment

Process mining can provide valuable insights in business processes using an event log containing process execution data. Despite the significant potential of process mining to support the analysis and improvement of processes, the reliability of process mining outcomes depends on the quality of the event log. Real-life logs typically suffer from various data quality issues. Consequently, thorough event log quality assessment is required before applying process mining algorithms. This paper introduces DaQAPO, the first R-package which supports flexible and fine-grained event log quality assessment. It provides a rich set of tests to identify a wide range of event log quality issues, while having sufficient flexibility to allow the detection of context-specific quality issues.