Level Of Pragmatism Research Articles

Interpretation and Application of General Anti-Avoidance Rules after BEPS and ATAD: Nordic Perspectives

This paper compares general measures against tax avoidance and the design of general anti-avoidance rules (GAARs) in Denmark, Finland, Norway, and Sweden. It focuses on aspects such as tax benefits, tax purposes, economic substance, and breaches of legislative purpose. The paper also examines potential compliance issues between national GAARs, tax treaties, and the European Union’s Anti-Tax Avoidance Directive (ATAD). The analysis highlights variations in how the national GAARs apply economic substance considerations and the level of pragmatism allowed when assessing conflicts with the purpose of the circumvented legislation. Additionally, it shows that differences in the wording of the GAARs, such as requirements related to tax purposes, do not necessarily result in practical differences due to other GAAR elements reducing or nullifying them. For similar reasons, the authors conclude that compliance issues between the national GAARs and the ATAD GAAR’s requirements are unlikely, despite some differences in wording. Whilst focusing on the Nordic region, the paper offers insights relevant to broader international contexts, as the diverse approaches, distinctions, and issues identified mirror tax developments worldwide.

A study on academic dishonesty among English as a foreign language students

Academic dishonesty is prevalent and has unfortunately become normalized in post-secondary institutions worldwide. The COVID-19 pandemic more than two years ago led to an increase in cheating and confrontation of instructors with academic honesty. The main objective of this study was to create an explicative model according to the levels of morality, pragmatism, and gender. Researchers applied an online questionnaire to 735 anonymous university students. Analysis showed that participants were less honest in morality than in pragmatism, but the average value was very close for both dimensions. A substantial number of students with low and moderate levels of dishonesty were observed in both moral and pragmatic contexts. The initial hypothesis was partially validated, as the level of morality was associated with the level of pragmatism rather than gender, indicating a direct albeit moderate impact of pragmatism on morality. We confirmed the second hypothesis, showing the influence of gender and morality on the level of pragmatism. Participants suggested that English as a Foreign Language instructors should modify their approach, account for ethical considerations, offer extra classes, revise teaching and evaluation methods, and sanction students who cheat. Surprisingly, results show a slight tendency for lower honesty in morality compared to pragmatism. Despite honest behaviors, it is essential to address gender differences and promote academic honesty through education, policies, and a culture of honesty.

The need for more pragmatic trials in glaucoma research.

There have been a number of clinical trials in glaucoma research published in the past two decades. Most of these trials were designed to evaluate very specific issues in selected populations placing them in the explanatory end of the pragmatic-explanatory continuum. The purpose of this study was to assess the level of pragmatism of published randomized controlled trials in glaucoma. A PubMed search using 'glaucoma' from 1995 to 2022 and randomized controlled trial (RCT) article type was done. Each study was assessed by three independent examiners using the Pragmatic-Explanatory Continuum Indicator Summary version 2 (PRECIS-2) toolkit. Scores were calculated for each study to determine the level of pragmatism. A summed score ≥36 was indicative of a very pragmatic study. Thirty-two different articles were included in the analysis. These papers represented 13 different landmark trials. The median PRECIS-2 score was 32 (range, 25 for the Early Manifest Glaucoma Trial (EMGT) to 34 to the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Ocular Hypertension Treatment Study). The Treatment of Advanced Glaucoma Study (TAGS), was considered very pragmatic and scored 33 points. Despite the number of RCTs in glaucoma, there is still a need for more pragmatic studies.

Heuristics and the Choice of Method in Entrepreneurial Marketing Education

This article exhibits that entrepreneurial marketing educators recur to their own heuristics to deal not only with the challenges that relate to their mentees’ entrepreneurial projects, but also with the operationalization of their teaching and methodological approaches. Based on the identification of heuristics derived from a convenience sample of 20 entrepreneurship educators, this research characterizes four archetypes of educators: academics, experts, entrepreneurs-in-residence, and mentors. Findings indicate that academics refer to the most common and successful practices, whereas experts qualify methods that fulfill their purposes and follow best practices. Entrepreneurs-in-residence mirror their own startup experiences, involving a certain level of pragmatism, and mentors base their decisions on experience, choosing practices that they judge suitable. Each profile tends to replicate heuristics patterns in the selection of the education method, suggesting an impossibility to separate context and experience from the methodological choices that determine entrepreneurial marketing education, whose learning process is presented as an adapted version of the model originally proposed by Kolb for students. This article contributes to the academic discussion of the role of educators in entrepreneurial marketing, offering an exploratory explanation as to why and how different educator profiles choose their teaching and methodological approaches.

Describing Engagement in the HIV Care Cascade: A Methodological Study.

Engagement in the HIV care cascade is required for people living with HIV (PLWH) to achieve an undetectable viral load. However, varying definitions of engagement exist, contributing to heterogeneity in research regarding how many individuals are actively participating and benefitting from care. A standardized definition is needed to enhance comparability and pooling of data from engagement studies. The objective of this paper was to describe the various definitions for engagement used in HIV clinical trials. Articles were retrieved from CASCADE, a database of 298 clinical trials conducted to improve the HIV care cascade (https://hivcarecascade.com/), curated by income level, vulnerable population, who delivered the intervention, the setting in which it was delivered, the intervention type, and the level of pragmatism of the intervention. Studies with engagement listed as an outcome were selected from this database. 13 studies were eligible, of which five did not provide an explicit definition for engagement. The remaining studies used one or more of the following: appointment adherence (n=6), laboratory testing (n=2), adherence to antiretroviral therapy (n=2), time specification (n=5), intervention adherence (n=5), and quality of interaction (n=1). This paper highlights the existing diversity in definitions for engagement in the HIV care cascade and categorize these definitions into appointment adherence, laboratory testing, adherence to antiretroviral therapy, time specification, intervention adherence, and quality of interaction. We recommend consensus on how to describe and measure engagement.

The Importance of Pragmatic Study Design to the Scholarly Influence of Surgical Hip Fracture Randomized Controlled Trials

Surgical randomized controlled trials (RCTs) have potential drawbacks, leading some to question their role in filling the information gap in orthopaedic surgery. Pragmatism in study design was introduced to increase the clinical applicability of study results. The purpose of this study was to examine how pragmatism affects the scholarly influence of surgical RCTs. A search for surgical hip fracture-related RCTs published between 1995 and 2015 was done. Journal impact factor, citation number, research question, significance and type of outcome, number of centers involved, and the Pragmatic-Explanatory Continuum Indicator Summary-2 level of pragmatism score were recorded for each study. Scholarly influence was estimated by a study's inclusion into orthopaedic literature or guidelines or through the study's average yearly citation rate. One hundred sixty RCTs were included in the final analysis. A multivariate logistic regression identified large study sample size as the only predictor of an RCT being used in clinical guidance texts. Large sample size and multicenter RCTs were predictors of high yearly citation rates. The level of pragmatism in study design did not predict scholarly influence. Pragmatic design is not independently associated with increased scholarly influence; however, large study sample size was the most important study characteristic affecting scholarly influence.

Intimacy and Race in Late Soviet Central Asia

Intimacy and Race in Late Soviet Central Asia

INDONESIAN WOMEN ELECT: THE STUDY OF ISLAMIC PHILOSOPHY

Women's participation in Indonesian politics gives its own color for the democracy of the nation. The number of female voters in the DPT of General Election 2019 is greater than the number of male voters, becoming an important key to the future direction of Indonesia's politics, democracy, and governance. This causes women's voices to become significantly valuable as the entry gate for the struggle and the development of the face of Indonesian politics, democracy, and governance. In this study, descriptive qualitative method was used with the Secondary Data Analysis (ADS) approach which utilized secondary data as the main research data related to the phenomenon of women's choice in the 2019 Presidential Election. The main objective of the current research is to see and analyze the level of adherence, pragmatism, fanaticism, and political intelligence of Indonesian women in making decisions to give their vote in the Presidential Election 2019 in a philosophical study. In terms of democratic presidential elections, philosophically if we believe in a democratic system as a form of sovereignty in the hands of the people, it is appropriate that the people directly elect the executive authorities, which in this case are the president and vice president. The elected president and vice president will further be responsible for the people who choose them, in this case is taking care, protecting, and guaranteeing the welfare of all people, including women. Therefore, there are several factors behind women's decisions in determining or voting which pair of president and vice president they think is ideal.

Generalizability of randomized controlled trials in primary health care: Applying the PRECIS-2 tool on published protocols.

Pragmatic design may facilitate the generalizability of effectiveness of randomized controlled trials (RCTs) in primary health care (PHC). The aim of this study was to investigate whether published protocols in PHC were designed pragmatically and to explore whether specific trial characteristics may be related to a pragmatic design. Using the Pragmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2), we assessed pragmatism for 123 published RCT protocols. For each domain, we calculated the mean score with the 95% confidence interval (95% CI). Interrater reliability was assessed by weighted κ-coefficient with 95% CI. We examined potential associations of published protocol characteristics with overall pragmatism by performing univariate and multivariate analyses. We observed the highest score for primary analysis (4.66, 95%CI: 4.51, 4.82). The eligibility score was intermediate (3.16, 95%CI: 3.01, 3.32). Domains with scores towards the explanatory side included organization (2.50, 95%CI: 2.36, 2.63), flexibility of delivery (2.74, 95%CI: 2.60, 2.88) and flexibility of adherence (3.00, 95%CI: 2.83, 3.17). Interrater agreement was good (κ = 0.61; 95%CI: 0.34, 0.80; p < 0.001). Higher sample sizes were correlated to a pragmatic design (odds ratio: 6.86, 95%CI: 1.64, 28.75; p = 0.04). Most RCT protocols were rated as intermediate in the pragmatic-explanatory continuum. Future research may guide all stakeholders on how best to incorporate the level of pragmatism in the interpretation of the resultsso that the trials are more likely to be applicable in real-world settings.

ONLINE UNIVERSITY TEACHING SYSTEM, WITH 7 MODULES, QUANTIFIED WITH EXPERIENCE POINTS (XP), IN COMPUTER-ASSISTED TRAINING, PSYCHOPEDAGOGICAL TRAINING MODULE

Abstract. In the present study, a gamified didactic system structured on 7 modules was built. Each training module offered students mandatory and optional assignments. A number of 53 assignments were designed for this didactic system, distributed on the 7 modules, of which 23 assignments were mandatory and 30 were optional. Each assignment had an equivalent number of experience points (XP). For the correct solving of each assignment the student received the grade "admitted" and the equivalent XP. It was verified, by evaluating the implemented system, the general level of attractiveness and students' perceptions on the level of pragmatism and on the hedonic aspect. Our research has shown that the degree of attractiveness of this system has been high enough to motivate us to implement it in the future. The stimulation and innovation that such a system brings are strong points that can promote involvement in didactic activity, but we must look for very effective ways to properly condition the solving of as many assignments as possible.

Weight loss in primary care: A pooled analysis of two pragmatic cluster-randomized trials.

The aim of this study was to report the results of five weight-loss interventions in primary care settings in underserved patients and to compare the level of pragmatism across the interventions using the Pragmatic Explanatory Continuum Indicator Summary (PRECIS-2) tool. Data from 54 primary care clinics (2,210 patients) were pooled from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) and Rural Engagement in Primary Care for Optimizing Weight Reduction (REPOWER) cluster-randomized trials. Clinics were randomized to one of five comparators: PROPEL usual care, PROPEL combination of in-clinic and telephone visits, REPOWER in-clinic individual visits, REPOWER in-clinic group visits, or REPOWER telephone group visits. At 24 months, weight loss (kilograms) was -0.50 (95% CI: -1.77 to 0.76), -3.05 (-4.10 to -2.01), -4.30 (-5.35 to -3.26), -4.79 (-5.83 to -3.75), and -4.80 (-5.96 to -3.64) in the PROPEL usual care, REPOWER in-clinic individual visits, REPOWER telephone group visits, REPOWER in-clinic group visits, and PROPEL in-clinic and telephone visits arms, respectively. At 24 months, percentage of weight loss was -0.360 (-1.60 to 0.88), -3.00 (-4.02 to -1.98), -4.23 (-5.25 to -3.20), -4.67 (-5.69 to -3.65), and -4.69 (-5.82 to -3.56), respectively, in the five arms. The REPOWER in-clinic individual visits intervention was the most pragmatic and reflects the current Centers for Medicare and Medicaid Services funding model, although this intervention produced the least weight loss. Clinically significant weight loss over 6 months in primary care settings is achievable using a variety of lifestyle-based treatment approaches. Longer-term weight-loss maintenance is more difficult to achieve.

Protocol refinement for a diabetes pragmatic trial using the PRECIS-2 framework

BackgroundThis report describes how we refined a protocol for a pragmatic comparative effectiveness study of two models of an evidence-based diabetes shared medical appointment intervention and used the PRECIS-2 rating system to evaluate these adaptations.MethodsWe report primary data collected between June and August 2019, and protocol refinements completed between 2018 and 2020. Twenty-two members of the study team collaborated in protocol refinement and completed the PRECIS-2 ratings of study pragmatism. We discuss study design refinements made to achieve the desired level of pragmatism vs. experimental control for each of the nine PRECIS-2 dimensions. Study team members received training on PRECIS-2 scoring and were asked to rate the study protocol on the nine PRECIS-2 dimensions. Ratings were compared using descriptive statistics.ResultsIn general, the PRECIS-2 ratings revealed high levels of pragmatism, but somewhat less pragmatic ratings on the categories of Delivery and Organization (costs and resources). This variation was purposeful, and we provide the rationale for and steps taken to obtain the targeted level of pragmatism on each PRECIS-2 dimension, as well as detail design changes made to a) make the design more pragmatic and b) address COVID-19 issues. There was general agreement among team members and across different types of stakeholders on PRECIS-2 ratings.ConclusionsWe discuss lessons learned from use of PRECIS-2 and experiences in refining the study to be maximally pragmatic on some dimensions and less so on other dimensions. This paper expands on prior research by describing actions to achieve higher levels of pragmatism and revise our protocol fit to the changed context. We make recommendations for future use of PRECIS-2 to help address changing context and other strategies for the planning of and transparent reporting on pragmatic research and comparative effectiveness research.Trial registrationClinicaltrials.gov Registration ID: NCT03590041.

China’s rise in Latin America and the Caribbean 1990–2019: navigating perceptions in the relationship

To date, perceptions of China's rise in relation to US hegemony in the international realm has not escaped scholarly scrutiny. For the period 1990–2019, the International Relations literature has made a somewhat copious contribution to the broader debates on the US and China. Within the Sino-Latin America Caribbean (LAC) discourse, the implications of China's ascent for US interests in the region is an underlying concern. The region is considered salient in broader power configurations as a result of its geostrategic positioning in relation to the US. However, perceptions pertaining to the triad of interests in the space account largely for powerful states in the dynamic. Despite the ambiguous perceptions associated with a rising China in the international realm and the Latin America Caribbean region's strategic position, rather than being preoccupied with ideas of the ‘China threat’, these states appear to have largely bypassed the more threatening rhetoric associated with China's rise in the period under scrutiny. In seeking to bring Latin America and Caribbean states into the discourse, the article examines how benign perceptions shaped the region's relationship with China. The argument is made that Latin America and Caribbean states sought to frame and navigate their relationship with China largely on the premise of economic opportunity amidst a firmly embedded US role inside the region which further repudiated ideas of the ‘China threat’ in the engagement. In unpacking the argument, the discussion seeks to show that more favourable images of China's economic ascent punctuated LAC states responses to China and that such states have been driven by a high level of economic pragmatism in the relationship. It also illustrates that the underlying hegemonic order has practical effects and more subtle manifestations inside LAC states which mitigated against perceptions of threat in China's rise in the region.

Healthy Habits, Happy Homes Scotland (4HS) feasibility study: Translation of a home-based early childhood obesity prevention intervention evaluated using RE-AIM framework

ObjectiveHealthy Habits, Happy Homes (4H) is a home-based, pre-school childhood obesity prevention intervention which demonstrated efficacy in North America which we translated to Scotland (4HS) by considering contextual factors and adapting study design. RE-AIM Framework was used to assess 1) extent to which development of 4HS intervention (including recruitment) was participatory and inclusive; 2) feasibility of translating a complex public health intervention from one setting to another; 3) extent to which translation was pragmatic and 4) fidelity of intervention to the principles of Motivational Interviewing (MI). Study designFeasibility testing, process evaluation and measurements of intervention fidelity were undertaken to evaluate the translation of 4H to an economically deprived area of Scotland (4HS). Methods4HS study processes; participatory approach, recruitment methods, level of pragmatism were evaluated using the RE-AIM framework. Qualitative and quantitative measures identified key implementation features and functioning of 4HS intervention. Fidelity MI principles was determined through coding of audiotapes using Motivation Interviewing Treatment Integrity (MITI) code. ResultsKey facilitators for positive impact with families, included: inclusive recruitment methods, appropriate channels of communication and correspondence (Reach) with n ​= ​126 enquiries and n ​= ​26 (21%) families recruited. Positive links with local parents and community workers integral to the research process at n ​= ​9 meetings (Effectiveness). 61.5% of families lived in the most deprived data zone in Scotland, 23% were one parent families, thus awareness and consideration of local contextual factors (Adoption) and locally relevant materials were important. 4HS was feasible to deliver, pragmatic in nature and intervention demonstrated good fidelity to MI (Implementation). ConclusionTranslation of 4H from North America to Scotland was successful. Future studies should consider implementation of 4HS approach within routine practice within the UK (practice based evidence) or through thoughtful evaluation in a future trial (evidence based practice).

Pragmatic Trials in Genomic Medicine: The Integrating Pharmacogenetics In Clinical Care (I-PICC) Study.

Pragmatic clinical trials (PCTs) have an established presence in clinical research and yet have only recently garnered attention within the landscape of genomic medicine. Using the PRagmatic‐Explanatory Continuum Indicator Summary 2 (PRECIS‐2) as a framework, this paper illustrates the application of PCT principles to The Integrating Pharmacogenetics In Clinical Care (I‐PICC) Study, a trial of pharmacogenetic testing prior to statin initiation for cardiovascular disease prevention in primary care. The trial achieved high engagement with providers (85% enrolled of those approached) and enrolled a representative sample of participants for which statin therapy would be recommended. The I‐PICC Study has a high level of pragmatism, which should enhance the generalizability of its findings. The PRECIS‐2 may be useful in the design and evaluation of PCTs of genomic medicine interventions, contributing to the generation of evidence that can bridge the gap between genomics innovation and clinical adoption.

2131Pragmatic clinical trials in cardiovascular medicine: trends over time in major medical journals

Abstract Background Pragmatic trials provide results that may be more applicable to the population in which the intervention will be eventually applied and are discussed extensively in the current healthcare environment. The aim of this study was to investigate how pragmatic or explanatory cardiovascular (CV) randomized controlled trials (RCT) are, if this was changing over time, and if they were more or less likely to meet their primary endpoint. Methods Using the six top-ranked (based on impact factors) medical and CV journals, all CV-related RCTs that were published during the years of 2000, 2005, 2010 and 2015 were identified, data extracted and reviewed by 2 adjudicators. The PRECIS-2 tool was used to evaluate the level of pragmatism. PRECIS-2 uses a 5-point ordinal scale (ranging from very pragmatic to very explanatory) across 9 domains of trial design, including eligibility, recruitment, setting, organization, intervention delivery, intervention adherence, follow-up, primary outcome, and analysis. A higher score indicates a more pragmatic score on an individual domain, and aggregated scores are a simplified formula across all domains. Cohen's D was used to quantify the mean difference relative to the variation. Results There were 616 RCTs, distributed evenly over the 2 decades, and 64% achieved their primary endpoint. The mean (±SD) PRECIS-2 score was 3.26±0.70 among 616 included RCTs. The level of pragmatism increased over time from a score of 3.07±0.74 in 2000 to 3.47±0.67 in 2015 (p&lt;0.0001 for trend; Cohen's D relative effect size 0.57). The increase in pragmatism occurred mainly in the domains of eligibility, setting, intervention delivery, and primary endpoint (Figure). PRECIS-2 score was higher for neutral trials than those with positive results (p=0.0015) and in phase III/IV trials as compared to phase I/II trials (p&lt;0.0001) (Figure). Furthermore, trials that involve more sites, with larger sample sizes, longer follow-ups, and those with mortality as the primary endpoint were found to be more pragmatic. There was no difference in the level of pragmatism between different sources of funding (public, industry, or both; p=0.52). Study characteristics and pragmatism Conclusion The PRECIS-2 tool can be used for appraising trials to assess their placement in the pragmatic-explanatory continuum. The level of pragmatism increased over time in CV trials. Greater focus on the design and delivery of CV trials will be required for the broad application. Acknowledgement/Funding Dr. Sepehrvand receives scholarship from Alberta Innovates Health Solutions.

Are trials of psychological and psychosocial interventions for schizophrenia and psychosis included in the NICE guidelines pragmatic? A systematic review

The NICE clinical guidelines on psychosocial interventions for the treatment of schizophrenia and psychosis in adults are based on the results of randomized controlled trials (RCTs), which may not be studies with a pragmatic design, leading to uncertainty on applicability or recommendations to everyday clinical practice. To assess the level of pragmatism of the evidence used to develop the NICE guideline for psychosocial interventions in psychoses. We conducted a systematic and critical appraisal of RCTs used to develop the 'psychological therapy and psychosocial interventions' section of the NICE guideline on the treatment and management of psychosis and schizophrenia in adults, published in 2014. For each study we assessed pragmatism using the pragmatic-explanatory continuum indicator summary-2 (PRECIS-2) and the Cochrane risk of bias tool. The mean score of PRECIS-2, averaging across nine domains, was calculated to describe the level of pragmatism of each individual study. A total of 143 studies were included in the analysis. Based on the PRECIS-2 tool, 16.8% were explanatory, 33.6% pragmatic, and 49.7% were rated in an intermediate category. Compared to explanatory studies, pragmatic studies showed a lower risk of bias. Additionally, pragmatism did not significantly improve over time, and no associations were found between pragmatism and a number of trial characteristics. However, studies with a UK leading investigator had the highest mean score of pragmatism. Cognitive behavioural therapy (CBT), art therapy, family intervention, psychoeducation, and adherence therapy, showed the higher average pragmatism scores. Two third of studies used to produce NICE recommendations on psychosocial interventions for the treatment of schizophrenia and psychosis in adults are based on studies that did not employ a pragmatic design.

Trends in the Explanatory or Pragmatic Nature of Cardiovascular Clinical Trials Over 2 Decades

Pragmatic trials test interventions using designs that produce results that may be more applicable to the population in which the intervention will be eventually applied. To investigate how pragmatic or explanatory cardiovascular (CV) randomized clinical trials (RCT) are, and if this has changed over time. Six major medical and CV journals, including New England Journal of Medicine, Lancet, JAMA, Circulation, European Heart Journal, and Journal of the American College of Cardiology. All CV-related RCTs published during 2000, 2005, 2010, and 2015 were identified and included. Included RCTs were assessed by 2 independent adjudicators with expertise in RCT and CV medicine. The outcome measure was the level of pragmatism evaluated using the Pragmatic Explanatory Continuum Index Summary (PRECIS)-2 tool, which uses a 5-point ordinal scale (ranging from very pragmatic to very explanatory) across 9 domains of trial design, including eligibility, recruitment, setting, organization, intervention delivery, intervention adherence, follow-up, primary outcome, and analysis. Of 616 RCTs, the mean (SD) PRECIS-2 score was 3.26 (0.70). The level of pragmatism increased over time from a mean (SD) score of 3.07 (0.74) in 2000 to 3.46 (0.67) in 2015 (P < .001 for trend; Cohen d relative effect size, 0.56). The increase occurred mainly in the domains of eligibility, setting, intervention delivery, and primary end point. PRECIS-2 score was higher for neutral trials than those with positive results (P < .001) and in phase III/IV trials compared with phase I/II trials (P < .001) but similar between different sources of funding (public, industry, or both; P = .38). More pragmatic trials had more sites, larger sample sizes, longer follow-ups, and mortality as the primary end point. The level of pragmatism increased moderately over 2 decades of CV trials. Understanding the domains of current and future clinical trials will aid in the design and delivery of CV trials with broader application.

Study characteristics impacted the pragmatism of randomized controlled trial published in nursing: a meta-epidemiological study

ObjectivesThe objective of this study was to examine the impact of study characteristics on the score of the pragmatism/explanatory continuum of randomized controlled trials (RCTs) published in nursing journals using the PRagmatic Explanatory Continuum Indicator Summary (PRECIS)-2 tool. Study Design and SettingRCTs concerning five themes of nursing care indexed in the PubMed and CINAHL databases published from 2002 to 2005 and 2012 to 2015 were selected by title/abstract. A sample of 400 was randomly selected and evaluated with the PRECIS-2 tool and reading grid. ResultsThe median PRECIS score was 32 of a possible 45 [28; 36] corresponding to a medium level of pragmatism. Studies with “medication” as an intervention had a more explanatory PRECIS score than studies with other intervention types (P = 0.015). Studies with “placebo” and “no usual care” as comparators had a more explanatory PRECIS score (P = 0.0027). The pragmatism/explanatory level was unaffected by impact factor (P = 0.42), h-index of the first and last author (P = 0.27 and P = 0.25, respectively), funding (P = 0.32), blinding (P = 0.41), sample size (P = 0.22), and time (P = 0.11). ConclusionThis study highlights the pragmatism/explanatory level of nursing RCTs, the impact of the field of the article, and the comparator type on the pragmatism of these studies. Further studies are needed to confirm the astonishing result that blinding resulted in no significant difference in the PRECIS score.

Can Pay-As-You-Go, Digitally Enabled Business Models Support Sustainability Transformations in Developing Countries? Outstanding Questions and a Theoretical Basis for Future Research

This paper examines the rapidly emerging and rapidly changing phenomenon of pay-as-you-go (PAYG), digitally enabled business models, which have had significant early success in providing poor people with access to technologies relevant to the Sustainable Development Goals (SDGs) (e.g., for electricity access, water and sanitation, and agricultural irrigation). Data are analysed based on literature review, two stakeholder workshops (or “transformation labs”), and stakeholder interviews (engaging 41 stakeholders in total). This demonstrates the existing literature on PAYG is patchy at best, with no comprehensive or longitudinal, and very little theoretically grounded, research to date. The paper contributes to existing research on PAYG, and sustainability transformations more broadly, in two key ways. Firstly, it articulates a range of questions that remain to be answered in order to understand and deliver against the current and potential contribution of PAYG in affecting sustainability transformations (the latter we define as achieving environmental sustainability and social justice). These questions focus at three levels: national contexts for fostering innovation and technology uptake, the daily lives of poor and marginalised women and men, and global political economies and value accumulation. Secondly, the paper articulates three areas of theory (based on emerging critical social science research on sustainable energy access) that have potential to support future research that might answer these questions, namely: socio-technical innovation system-building, social practice, and global political economy and value chain analysis. Whilst recognising existing tensions between these three areas of theory, we argue that rapid sustainability transformations demand a level of epistemic pragmatism. Such pragmatism, we argue, can be achieved by situating research using any of the above areas of theory within the broader context of Leach et al.’s (2010) Pathways Approach. This allows for exactly the kind of interdisciplinary approach, based on a commitment to pluralism and the co-production of knowledge, and firmly rooted commitment to environmental sustainability and social justice that the SDGs demand.