Exploratory Sequential Mixed Methods Approach Research Articles

Assessing first-year engineering students' pre-university mathematics knowledge: Preliminary validity results based on an item response theory model

The importance of students’ prior knowledge to their current learning outcomes cannot be overemphasised. Students with adequate prior knowledge are better prepared for the current learning materials than those without the knowledge. However, assessment of engineering students' prior mathematics knowledge has been beset with a lack of uniformity in measuring instruments and inadequate validity studies. This study attempts to provide evidence of validity and reliability of a Norwegian national test of prior mathematics knowledge using an explanatory sequential mixed-methods approach. This approach involves use of an item response theory model followed by cognitive interviews of some students among 201 first-year engineering students that constitute the sample of the study. The findings confirm an acceptable construct validity for the test with reliable items and a high-reliability coefficient of .92 on the whole test. Mixed results are found on discrimination and difficulty indices of questions on the test with some questions having unacceptable discriminations and require improvement, some are easy, and some appear too tricky questions for students. Results from the cognitive interviews reveal the likely reasons for students' difficulty on some questions to be lack of proper understanding of the questions, text misreading, improper grasping of word-problem tasks, and unavailability of calculators. The findings underscore the significance of validity and reliability checks of test instruments and their effect on scoring and computing aggregate scores. The methodological approaches to validity and reliability checks in the present study can be applied to other national contexts.

An evaluation of community pharmacies’ actions under value-based payment

ObjectiveTo determine actions taken by community pharmacies to be successful under a value-based pharmacy program (VBPP). MethodAn exploratory sequential mixed methods approach was used to evaluate pharmacies participating in the VBPP, with qualitative data collected and analyzed in the first phase, followed by quantitative measurement through a 30-item survey instrument in the second phase. ResultsThe qualitative data showed that participating pharmacies were more involved with adherence and cardiovascular and diabetes metrics than with other metrics. Depression metrics received the lowest overall involvement. For total cost of care, different approaches were used; 5 pharmacies used the dashboard to identify likely high-cost patients they could try to manage, and 4 pharmacies monitored adherence to avoid complications that could contribute to increased cost. For the survey response rate was 72.6% (n = 53). The mean perception of level of success was 53.06 ± 20.15 (mean ± SD). Activities with the highest priority were adherence (1.98 ± 0.97) and diabetes care (2.04 ± 0.83), and the activity with the lowest priority was depression care (3.60 ± 1.10). The most frequently mentioned challenge was time availability, and the most common improvement suggestion was better communication between the insurer and providers. ConclusionIn conclusion, this study found that community pharmacies were transforming their practices to be successful under a commercial value-based payment program. The pharmacies tended to build on care processes already established (e.g., medication adherence, patients with diabetes or cardiovascular conditions) and developed new processes to address emerging metrics and associated patient needs (e.g., collecting and documenting blood pressure and hemoglobin A1c levels). Future research is needed to identify best practices for patient care and pharmacy success under broad VBPPs such as the one studied here.

A National Study of Community Health Centers' Readiness to Address COVID‐19

Research ObjectiveCommunity health centers (CHCs) serve as the patient medical home for populations that are disproportionately more susceptible to COVID‐19; yet, there is a lack of understanding of the current efforts in place by CHCs across the United States working to prepare for and respond to the current pandemic. The purpose of this mixed‐methods assessment was to understand community health centers’ needs and readiness to address COVID‐19.Study DesignWe conducted a sequential explanatory mixed‐methods approach. A pilot‐tested, web‐based, cross‐sectional survey regarding organizational and individual staff needs, and best practices currently in place to prepare for and prevent spread of COVID‐19, was administered to and completed by 240 primary care employees from 201 organizations across 44 states, the District of Columbia, and Puerto Rico. Focus group interviews were subsequently conducted with a convenience sample (n = 39) from the survey respondents to understand the needs and current efforts in place by CHCs across the United States working to prepare for and respond to COVID‐19. We applied the transcript‐based analysis approach to the focus group data and derived themes using the constant comparative method.Population StudiedThe majority of respondents (59%) held administrative leadership roles at their respective agencies, while the remainder of the participants served in patient‐facing roles as physicians (8%), nurses (13%), and medical support staff (20%). Over a third (38%) of the participants came from practices in the Northeast region of the country, with the rest of respondents coming from the West (19%), South (19%), and Midwest (23%) regions, and minor representation from Puerto Rico (1%).Principal FindingsRespondents identified guidance regarding COVID‐19 infection prevention and control (77.1%), safety precautions (72.1%), and screening, diagnostic testing, and management of patients (67.1%) as their major educational needs. Findings from the focus groups highlighted five key themes relevant to foundational aspects of readiness: leadership, communication, formal policies and procedures, resources, and workforce capacity. Responses from the focus groups clearly reflected the difficulty imposed on an already stretched, understaffed workforce in pivoting to rapidly address the expected surge in demand from patients related to the pandemic.ConclusionsThe COVID‐19 pandemic has exacerbated long‐standing capacity issues that CHCs face, making it challenging for these safety‐net practices to adequately respond to the current disease outbreak. In addition to the more universal concerns about lack of testing and personal protective equipment, these findings highlight the special challenge posed by lack of staffing resources in CHCs as recruitment and retention of staff in rural and other medically underserved practice locations has burdened health centers long before the current pandemic.Implications for Policy or PracticeThe COVID‐19 pandemic is occurring at a time when CHCs nationwide are experiencing great economic uncertainty. There is a need for Congress to prioritize reauthorization of funding for CHCs in order to prevent major hiring freezes, layoffs, and reduced patient care services, especially during a pandemic. Similarly, greater Federal financial support for CHCs is needed to ensure these practices have the capacity to continue serving the most vulnerable members of society, thereby helping relieve the stress on hospitals and flatten the spread of COVID‐19.

O papel dos profissionais de relações públicas na responsabilidade social corporativa: algumas notas a partir da realidade portuguesa

Os profissionais de relações públicas (RP) são envolvidos nos processos de decisão sobre cidadania corporativa (CC) ou apenas são chamados a divulgar as práticas das organizações a este nível? As organizações estão comprometidas com a responsabilidade social corporativa (RSC) ou com a cidadania corporativa? No âmbito de um paradigma pragmatista, foi desenvolvida uma abordagem explicativa sequencial recorrendo a métodos mistos. Foi realizada uma investigação em duas fases, uma fase inicial quantitativa de recolha e análise de dados, e de seguida uma fase de recolha e análise de dados qualitativa. Em outubro de 2018, foram convidadas a responder a um inquérito online as 158 organizações que pertencem a uma associação portuguesa para a promoção da CC (Grace). Posteriormente, foram realizadas entrevistas presenciais com o responsável pela RSC/CC organizações que responderam ao questionário. O estudo aponta para que a área social (filantrópica) seja a mais relevante nas organizações entrevistadas e que esta área da RSC está sob fortes reformulações. No entanto, as organizações parecem não utilizar o conceito de cidadania corporativa. Ao contrário do esperado pelos investigadores, os profissionais de comunicação parecem não assumir responsabilidades a nível estratégico.

Understanding the key competencies of market-ready building surveying graduates from employers’ perspectives

PurposeThis study aims to investigate the various competencies a graduate should hold to prepare them for graduate building surveying roles from employers’ perspective.Design/methodology/approachThis study uses a sequential exploratory mixed-method approach by informing a quantitative study with the finding from a qualitative study.FindingsBased on exploratory factor analysis, the study found that 13 essential competencies are valued by the employers when recruiting building surveying graduates, as they are requisites for effective job performance. Personal management skills, technical surveying knowledge and knowledge of the Royal Institute of Chartered Surveyor standards are the essential competencies based on the level of variance extracted by the three components. Other competency categories include client management skills, being goal-driven and self-motivated, optimistic personality traits, strong mental resilience, building maintenance and management knowledge and time management skills, among others that are explained in the paper.Originality/valueThe essential competencies were dependent on maintaining a balance between knowledge, skills and personality-based competencies. Measures and approaches for gaining the essential competencies, as well as their level of significance, are further discussed. The study will be of significant benefits to employers of graduate building surveyors, academic institutions that are seeking to improve their graduate employability, as well as students who are preparing for the world of work.

A model to enhance job satisfaction for radiographers in the public healthcare system in Gauteng province, South Africa

IntroductionThe World Health Organization seeks to address the maldistribution of healthcare professionals which results in inequitable services to underserved communities (World Health Organization (WHO), 2015). In South Africa, the underserved areas are the public sector hospitals and the rural areas. Radiographers, like other healthcare professionals, are also unequally distributed between the public and private sector hospitals, and between the rural and urban areas. Since one of the perceived factors for maldistribution is job satisfaction, it is essential to explore factors that contribute to job satisfaction/dissatisfaction amongst radiographers to develop a model to attract and retain radiographers in the public sector. MethodsThe study used exploratory sequential mixed methods approach to explore job satisfaction amongst radiographers, employed by public tertiary hospitals in the Gauteng province, South Africa. In phase one of the study (qualitative), individual and focus group interviews were used to collect data, and in phase two (quantitative), a self-developed questionnaire was used. The data collected was analyzed in sequential order, where thematic analysis was performed for phase one of the study, and SPSS version 23 was used in phase two. ResultsIn phase one, five themes emerged, namely the influence of government policies on job satisfaction, lack of career pathing, poor remuneration, working conditions, and the role of the human resources department. In phase two, the Pearson's correlation test was performed which showed that there was a significant correlation of intent to leave, p = .005 with the following factors: government policy on Occupational Specific Dispensation (OSD) and Performance Management Development System (PMDS), working conditions, supervision, equipment and infrastructure, and poor remuneration. ConclusionGovernment policies, working conditions, and poor remuneration play a significant role in job satisfaction amongst radiographers employed by public tertiary hospitals in the Gauteng province. Implications for practiceThe proposed model could enhance job satisfaction for radiographers employed by the public sector hospitals and ultimately increase attraction and retention rates of radiographers for this sector.

Patterns of pesticide usage in agriculture in rural Tanzania call for integrating agricultural and public health practices in managing insecticide-resistance in malaria vectors

BackgroundUnrestricted use of pesticides in agriculture is likely to increase insecticide resistance in mosquito vectors. Unfortunately, strategies for managing insecticide resistance in agriculture and public health sectors lack integration. This study explored the types and usage of agricultural pesticides, and awareness and management practices among retailers and farmers in Ulanga and Kilombero districts in south-eastern Tanzania, where Anopheles mosquitoes are resistant to pyrethroids.MethodsAn exploratory sequential mixed-methods approach was employed. First, a survey to characterize pesticide stocks was conducted in agricultural and veterinary (agrovet) retail stores. Interviews to assess general knowledge and practices regarding agricultural pesticides were performed with 17 retailers and 30 farmers, followed by a survey involving 427 farmers. Concurrently, field observations were done to validate the results.ResultsLambda-cyhalothrin, cypermethrin (both pyrethroids) and imidacloprids (neonicotinoids) were the most common agricultural insecticides sold to farmers. The herbicide glyphosate (amino-phosphonates) (59.0%), and the fungicides dithiocarbamate and acylalanine (54.5%), and organochlorine (27.3%) were also readily available in the agrovet shops and widely used by farmers. Although both retailers and farmers had at least primary-level education and recognized pesticides by their trade names, they lacked knowledge on pest control or proper usage of these pesticides. Most of the farmers (54.4%, n = 316) relied on instructions from pesticides dealers. Overall, 93.7% (400) farmers practised pesticides mixing in their farms, often in close proximity to water sources. One-third of the farmers disposed of their pesticide leftovers (30.0%, n = 128) and most farmers discarded empty pesticide containers into rivers or nearby bushes (55.7%, n = 238).ConclusionSimilarities of active ingredients used in agriculture and malaria vector control, poor pesticide management practices and low-levels of awareness among farmers and pesticides retailers might enhance the selection of insecticide resistance in malaria vectors. This study emphasizes the need for improving awareness among retailers and farmers on proper usage and management of pesticides. The study also highlights the need for an integrated approach, including coordinated education on pesticide use, to improve the overall management of insecticide resistance in both agricultural and public health sectors.

Exploring the status and views of managed entry agreements in Saudi Arabia: mixed-methods approach

ABSTRACT Background Healthcare payers are increasingly adopting managed entry agreements (MEAs) between themselves and manufacturers, to overcome the challenge of sustaining access in an era of innovative and high-cost medicines. This study aims to investigate current MEA activity in Saudi Arabia and explore the challenges encountered when implementing such agreements. Methods An explanatory sequential mixed-methods approach was used. Quantitative data on MEAs were collected, followed by qualitative semi-structured interviews with different stakeholders. Results Our questionnaire garnered responses from 18 pharmaceutical companies from 3 different continents and identified 25 agreements in Saudi Arabia since 2010. Financial-based agreements were more prevalent than outcomes-based agreements at 44% versus 32%, respectively. Stakeholders showed positive attitudes toward MEAs, valuing their benefits in facilitating market access for both costly and innovative medicines. The main challenges included data availability, administrative and financial burden, lack of expertise, confidentiality, and lack of clear regulations. Conclusions Despite clear implementation challenges, a growing tendency toward MEAs exists in Saudi Arabia because of the potential benefits they bring to patients, healthcare providers, payers, and manufacturers. It is believed that the newly established health technology assessment center in Saudi Arabia will bring more clarity and shape the concept of MEAs in the country.

Behind the Mask: An Exploratory Assessment of Female Surgeons' Experiences of Gender Bias.

Though overt sexism is decreasing, women now experience subtle, often unconscious, gender bias as microaggressions. The authors sought to explore the prevalence and impact of the sexist microaggressions female surgeons experience, using a sequential exploratory mixed methods approach (January 2018-April 2018), to identify opportunities for education and prevention. First, all resident, fellow, and attending female surgeons at the University of New Mexico Health Sciences Center (UNM HSC) were invited to participate in focus groups conducted by experienced moderators using a semistructured interview guide based on the 7 Sexist Microaggressions Experiences and Stress Scale (Sexist MESS) domains. Qualitative analysis was performed using line-by-line manual coding to identify themes aligned with the Sexist MESS domains as well as other gender bias experiences of female surgeons. Next, a survey was sent to all resident, fellow, and attending female surgeons at the UNM HSC, which included the Sexist MESS questionnaire and questions related to surgeon-specific experiences of gender bias that the authors developed based on major thematic categories from the focus groups.Four focus groups of 23 female surgeons were conducted, revealing 4 themes: exclusion, increased effort, adaptation, and resilience to workplace slights. The survey response rate was 64% (65/101 surgeons). Across Sexist MESS domains, the frequency and severity of microaggressions was higher for trainees than attendings. The variables of non-White race/ethnicity, having children under 18, and fellowship training generally did not demonstrate statistical significance. This exploratory study adds to the growing body of evidence that gender bias in surgery continues and frequently manifests as microaggressions. Trainees reported the highest rates and severity of microaggressions and bias experiences. Further research should investigate how to address microaggressions, the experiences of male surgeons, the perspectives of medical students and groups who were reported as often perpetuating gender bias, and the efficacy of possible interventions.

Impact of Parental Involvement on Pre-Tertiary Learners’ Academic Development and Performance in Ghana.

The purpose of this study was to investigate the impact of parental involvement on pre-tertiary learners’ academic performance and development in some selected pre-tertiary schools in the Ada East District of Greater Accra Region of Ghana. The study adopted the sequential explanatory mixed method approach. That is, quantitative data were initially gathered through a 3-point Likert Scale response set structured questionnaire followed by a qualitative interview data. The study made use of fifty (50) respondents who were randomly and judgmentally sampled. Both questionnaire and interview guide were developed to collect data on two formulated research questions after which they were descriptively and thematically analysed respectively. The study revealed that learners’ academic development and performance move along with parents’ financial commitment and other socioeconomic related characteristics, parents’ level of training, education and other sociocultural related characteristics as well as parents’ relationship and communication with teachers, school community and the community outside. It was concluded therefore that both socioeconomic and sociocultural statuses of parents affect academic development and performance of learners in pre-tertiary schools to a large extent. Conclusion was also drawn on how parents’ relationship and communication with the school community, teachers and the community outside contribute to pre-tertiary school learners’ development and performance. The study strongly recommended full parental, community and stakeholders’ commitment in all academic related activities of learners.

Secondary Education During Lockdown Situation Due to Covid-19 Pandemic in Bangladesh: Teachers’ Response on Online Classes

Online classes started in many secondary schools one month after the compulsory closure of all education institutions in Bangladesh. This study explores the current scenario as well as challenges of adaptation of online classes in secondary education in terms of teachers’ experience. The study followed sequential exploratory mixed-method approach. Five secondary teachers were interviewed and 54 secondary teachers from 17 districts in Bangladesh were surveyed over telephone, Google forms and by email. The quantitative data was analyzed with Microsoft Excel and the thematic analysis approach had been followed for the qualitative one. The findings revealed that a good number of teachers have started teaching online by using social media platforms despite of not having any training or experience. Very few respondent teachers were found to take online examination; instead they are trying to assess the students from the feedback of given home works and home assignments. Teachers are facing numerous challenges like deficit of digital equipment, lack of expertise, unfamiliarity with the LMS, proficiency in assessment technique etc. The paper concludes with few recommendations such as providing proper devices to the teachers and students to participate in online class; facilitate rigorous training to enhance technology-based skills and capacities of the teachers so as to get the expected outcome. Keywords: Secondary education, Education in pandemic, Online class, Teachers’ response. DOI: 10.7176/JEP/11-20-11 Publication date: July 31 st 2020

Exploring Aspects of Open Educational Resources Through OER-Enabled Pedagogy

In the last decade, much research has taken place that examines various aspects of Open Educational Resources (OER); while, more recently, educators have begun to explore OER-enabled pedagogy. This study uses an explanatory sequential mixed method approach and is unique in that it incorporates the variable of “engagement” with the original “cost,” “outcomes,” “usage,” and “perception” (COUPE) constructs that are often measured in OER research. It is also unique in that it explores OER-enabled pedagogy through the lens of the COUPE framework. This study analyzes the results of the COUPE framework as applied to an undergraduate general education introductory nutrition course at a public university. Course sections involved utilized OER and OER plus open pedagogy. Quantitative and qualitative data were gathered to assess possible differences between the OER and OER plus sections. Conclusions indicate relatively few differences, although the overall response to OER was generally positive across sections, and the OER-enabled pedagogical approach was viewed as positive.

Research data management literacy amongst lecturers at Strathmore University, Kenya

PurposeThe purpose of this study was to analyse the skills required by lecturers to be able to support research data management effectively; assess the research data management literacy levels amongst lecturers at Strathmore University; and suggest how research data management capacity can be strengthened to mitigate the knowledge gaps identified.Design/methodology/approachThis study was conducted as a mixed methods research. Explanatory sequential mixed methods approach was used to collect, analyse and interpret quantitative and qualitative data from lecturers at Strathmore University in Nairobi, Kenya. Quantitative data was collected using questionnaires while qualitative data was collected through focus group discussions. Quantitative data was analysed using SPSS while qualitative data was analysed thematically.FindingsThe findings of this study indicate varied levels of research data management literacy amongst lecturers at Strathmore University. Lecturers understand the need of having literacy skills in managing research data. They also participate in data creation, collection, processing, validation, dissemination, sharing and archiving. This is a clear indication of good research data management. However, the study also revealed gaps in research data management skills amongst the lecturers in areas such as sharing of research data on open access journals, data legislation and securing research data.Research limitations/implicationsThe study has been conducted in one university in Kenya. However, the findings have been contextualised in the global landscape through suitable references.Practical implicationsThe findings of this study may be used to attract the attention of lecturers and librarians to research data management. The findings may also be used to develop institutional policies on research data management at Strathmore University and beyond. The suggested ways of research data capacity strengthening can be adopted or adapted by other universities to enhance research data management.Originality/valueThis is an original study.

Socioeconomic implications of national flood insurance policy reform and flood insurance rate map revisions

Flooding exacerbated by climate change has resulted in more mandatory community participation in the Federal Emergency Management Agency (FEMA) National Flood Insurance Program (NFIP). The purpose of this research is social regulatory floodplain criteria that may have an impact on various socioeconomic factors at the county and sub-county level. Updated mapping can result in widespread changes to the NFIP Special Flood Hazard Area, while no socioeconomic vulnerability assessments are completed before changes in risk designation or subsidy elimination occurs. These changes can result in additional compulsory flood insurance policies, heightened policy costs, and ultimately produce socioeconomic barriers for lower-income residents. The objectives include demonstrating the potential nationwide implications of increasing community risk with these changes to national policy through a case study from Ada County, Idaho where FEMA began updating the floodplain maps in 2015. Ada County was chosen for being reflective of other communities that may be suffering similar impacts from NFIP policy. A sequential explanatory mixed-methods approach was employed using semi-structured interviews, spatial analysis, and the Spatially Explicit Resilience-Vulnerability (SERV) model to assess potential community impacts. Results indicate increased vulnerability in the revised floodplain. Total annual sales volume, employee numbers, industry sectors, and overall community vulnerability are higher in the revised floodplain. Interviews with community leaders corroborated these results. This case study provides a foundation for further research on the impacts of flood insurance on communities across the USA while discussing the social injustice of a national program that is likely promoting the upward distribution of wealth county by county.

Building organization and employee resilience in disaster contexts

PurposeThis study explored the resilience-building initiatives of work organizations using the Johns Hopkins Resistance–Resilience–Recovery Model. It also determined how resilience-building initiatives increase organizational resilience and promote employee resilience.Design/methodology/approachThe study employed an exploratory sequential mixed-methods approach. In Study 1, resilience-building initiatives of selected work organizations in the Philippines were determined through qualitative research. A survey questionnaire to determine the presence of resistance, resilience and recovery programs in organizations was developed based on the results of this qualitative study. In Study 2, the empirical relations of these initiatives to reported levels of perceived organizational resilience as well as individual employee resilience were determined through a quantitative survey among employees. Data was analyzed using structural equation modeling.FindingsThe findings of the study described resistance, resilience and recovery programs in work organizations. Results also supported the hypothesis that the presence of resilience-building initiatives contributes to organizational resilience, which in turn affects employee resilience.Research limitations/implicationsThe relatively low contribution of organization initiatives on organization resilience suggests that other factors may need to be explored. Also, despite using a sequential mixed-method approach, conducting longitudinal studies in future research will provide more robust data on the impact of interventions on resilience.Practical implicationsManagement may use the results in identifying initiatives that can increase resilience in their organizations. The tool created may be utilized in gathering data on initiatives and help those in-charge of disaster risk reduction and management build a business case on the importance of investing in resilience-building efforts.Originality/valueThe study identified resilience-building initiatives of work organizations in a country that regularly experiences disasters as well as demonstrated the utility of the Johns Hopkins Model as framework for resilience building in the workplace. A survey questionnaire to determine the presence of resistance, resilience and recovery programs in organizations was developed through the exploratory study (Study 1), and the contributions of these initiatives to resilience of employees and organizations were established in Study 2.

Fire safety management of public buildings: a systematic review of hospital buildings in Asia

PurposeThere is increasing recognition amongst healthcare providers on the necessity to improve fire safety management in healthcare facilities. This is possibly not yet satisfactory because of recent fire incidents in Asia. This paper set out to analyse the literature because of the paucity of systematic reviews on fire safety management of public healthcare facilities and proffer preventive measures.Design/methodology/approachThirty related studies were identified with the support of the Preferred Reporting Items for Systematic reviews and Meta-Analyses via Scopus and Web of Science databases.FindingsInfluencing factors, hindrances to fire safety management and preventive measures for fire-related occurrence in Asian hospital buildings were the three themes that emerged from the reviewed. The factors that influence fire in Asian hospital buildings were categorised into technical, management and legislation factors.Research limitations/implicationsThe recommendations of this paper were based on literature that was systematically reviewed but does not compromise the robustness concerning fire safety management in hospital buildings across Asian countries. Much is needed to be known regarding fire safety in healthcare buildings across Asian countries. This paper recommended exploratory sequential mixed-methods approach as part of the implications for further studies. This will allow in-depth face-to-face interviews and increase the generalisability of future findings concerning fire safety management in hospital buildings across Asian countries to a larger population.Practical implicationsAs part of the practical implications, this paper recommends fire safety management plan as one of the practical possible measures for addressing technical, management and legislation factors. Also recommended is training and fire safety education of healthcare staff in collaboration with safety firefighters to address major issues that may arise from management factors. The government should upgrade the safety technology equipment in healthcare facilities as part of measures to mitigate issues concerning technical and legislation factors. Also, the identified factors are part of the theoretical contributions to the advancement of knowledge and this brings to the front burners new opening.Originality/valueThis is probably the first systematic review paper on fire safety hospital buildings in Asia.

Exploring student perceptions and attitude towards various aspects of peer feedback in a pharmacotherapy course

BackgroundThe purpose of this study is to gauge pharmacy students' perceptions and attitude towards peer feedback in a pharmacotherapy course. MethodsAn explanatory sequential mixed-method approach with a 20-item electronic survey and semi-structured interviews were used to collect data from students enrolled in a required pharmacotherapy course at a major public university in the southeast United States. A survey design with descriptive statistics were used for the quantitative part and constant comparative approach was used to analyze qualitative data. ResultsSeventy-three completed surveys (53%) were received (n = 73). Majority of the students (90%) believed that they will be using peer feedback in their future pharmacy careers. Most students (90%) agreed that their peers are competent enough to provide constructive feedback, whereas only 78% believed in their own competency to provide feedback to their peers. Over 81% of students preferred receiving feedback from a peer they have previously worked with. Interviews with five second-year pharmacy students (n = 5) revealed three major themes regarding PharmD students' perception of peer feedback activity, namely, (1) participants' perspectives about the value of peer feedback, (2) learning from peer feedback, and (3) significance of the individuals participating in the peer feedback activities. ConclusionsPerceptions of competency, the perceived value of peer feedback and interrelationship among peers are important determinants of effective peer feedback practices. Education and training in techniques and benefits of peer feedback, as well as opportunity to practice the skill can help students promote a positive attitude towards peer feedback.

Energy drinks consumption and perceptions among University Students in Beirut, Lebanon: A mixed methods approach.

BackgroundEnergy drinks (ED) are caffeine- and sugar-rich beverages with other ingredients that are marketed for their energy-boosting and performance-enhancing effects. The consumption of these drinks, with and without alcohol, is dramatically increasing worldwide, despite the reported side effects and potential harms to consumers. Few studies, to date, have explored the perceptions and experiences of young adults towards these beverages.ObjectiveThe present study aimed to explore the consumption patterns and correlates of ED consumption, as well as the perceptions and experiences of university students in Lebanon towards these beverages.MethodsA sequential explanatory mixed-methods approach was adopted. Data collection was conducted in two private universities in Beirut, Lebanon. A self-administered 36-item quantitative survey was first used to explore the prevalence and correlates of ED consumption among a convenience sample of university students (n = 226). The survey included questions related to socio-demographic characteristics, anthropometric measurements, and other lifestyle behaviors, including physical activity of university students. The subsequent qualitative phase consisted of focus group discussions (FGD) conducted to further examine the perceptions and experiences of university students towards ED. Descriptive statistics and logistic regression analyses were conducted using survey data, whereas the transcribed FGD were analyzed thematically.ResultsA total of 226 university students completed the survey. Results showed that 45% of survey respondents consumed ED at least once in their life (ever consumers), among which 30% reported consumption of ED mixed with alcohol (AmED). Adjusting for socio-demographic and anthropometric characteristics, coffee and sports drinks consumption were significantly associated with ED (OR = 2.45, 95% CI = 1.20, 5.00, and OR = 4.88, 95%CI = 2.41, 9.88, respectively). In addition, physically active participants were 1.89 times (95%CI = 1.01, 3.51) more likely to consume ED compared to their inactive counterparts. During the qualitative phase, a total of six FGD were conducted with 29 university students, who reported consuming ED at least once per month. Three main themes were derived reflecting individual-, interpersonal/social- and environmental-level factors affecting ED consumption among university students. These themes were further supported by eight subthemes, including: perceived benefits of ED, experienced side effects, misinformation about content of ED, peer pressure and social image, as well as affordability and accessibility of ED.ConclusionFindings highlight the need for public health policies and programs to curb the growing public health phenomenon of ED consumption amongst university students. Such programs should consider the multi-level factors affecting ED consumption at the individual, interpersonal/social, and environmental levels, including educational campaigns on ED potential harms, regulating ED content and labeling, as well as restricting sales and marketing of these beverages, especially among young consumers.

Modelling the performance of waste management services in Ghana’s public hospitals

PurposeThe purpose of this paper is to explore and establish key performance indicators that could be considered towards improving the delivery of waste management (WM) services in public hospitals.Design/methodology/approachAn exploratory sequential mixed-methods approach was adopted for this study. This involved two phases of data collection and analysis. Specifically, interviews in selected case studies hospitals and a general questionnaire survey. Partial least squares structural equation modelling was used to model the relationships among the performance variables. An expanded balanced scorecard typology was used to categorize performance variables.FindingsThe results demonstrate that quality and internal business strategic indicators have a significant influence on WM performance. By implication, public hospital managers would be well advised to invest resources in improving internal business operations, learning and growths, as well as prioritizing finance in the process of managing healthcare waste.Practical implicationsThe developed WM structural model can be used to identify performance indicators that can be incorporated into public hospitals’ WM strategy to improve performance leading to a decent healthcare environment.Originality/valueThe majority of studies have centered on the knowledge and practices of healthcare WM. This study extends the knowledge of healthcare WM literature from the perspective of FM performance measurement. The developed model of the study is invaluable to many developing countries that are faced with the challenge of improving WM practices.

Parental Behaviors, Emotions at Bedtime, and Sleep Disturbances in Children with Cancer.

Poor sleep is common for children during cancer treatment, but there is limited understanding of the nature of children's sleep throughout the treatment trajectory. The current exploratory study used an explanatory sequential mixed method approach to examine quantitative associations among sleep problems in children with cancer, parental behavior, and children's sleep hygiene, with follow-up qualitative characterizations of children's sleep across cancer treatment stages. Eighty parents of children with cancer (aged 2-10 years; in active treatment, maintenance treatment, or off treatment) completed an online survey querying the child's sleep quality (Sleep Disturbance Scale for Children-Disorders of Initiating and Maintaining Sleep subscale) and behaviors (Child Sleep Hygiene Scale) and sleep-related parenting behaviors (Parental Sleep Strategies). A subsample (n = 17 parents) participated in qualitative interviews to better characterize the processes of children's sleep and parents' sleep-related behaviors. Children's sleep quality, sleep hygiene, or parental sleep strategies were not significantly different by cancer treatment groups. Greater sleep disturbance in children was associated with their parents' tendency to accommodate the child's bedtime requests. Qualitatively, cancer treatment-related anxiety in both children and parents influence the onset of these disruptive sleep behaviors. Parents' sleep-related behaviors affect children's sleep during cancer treatment. Parents' accommodation may start during active treatment to alleviate cancer-related challenges, and these behaviors may continue into maintenance therapy and off treatment to reinforce sleep disturbance. Behavioral interventions targeting unhelpful parental behaviors may improve sleep in children with cancer during and after cancer treatment.