Mixed Methods Study Research Articles

Gestational Diabetes Mellitus: Closely Monitored yet Ignored

Objective: To assess the perception and knowledge of women regarding gestational diabetes mellitus and to identify the barriers faced in acquiring health care and lifestyle modifications. Study Design: Mix Method Study. Place and Duration of Study: This study was carried out at Shifa College of Medicine and Shifa Foundation Community Health Centre, Islamabad Pakistan, from Jan to Jul 2020. Sixty women with gestational diabetes mellitus were recruited from a clinic in Shifa Foundation Community Health Centre. Methodology: A mix method study was carried out in Shifa international hospital. 60 patients suffering from gestational diabetes mellitus were recruited for the study in order to assess the awareness and knowledge of gestational diabetes mellitus among patients suffering from Gestational Diabetes Mellitus. Questionnaire based survey was carried out. Quantitative analysis was done using Microsoft excel. In the next phase. Four Focus group interviews were carried out by principal investigator in a selected area giving an ample amount of time for Focus Group Discussions. Perception of patients were inquired and predetermined questions were asked to guide the discussion. Data from each participant was tape recorded and transcribed using verbatim afterwards. Results: N=18(30%) of the population had much information on gestational diabetes mellitus while 24(40%) of them had some information, the rest had little or no information on it. A high percentage of respondents 21(35%) had a perception that gestational diabetes mellitus has future effects on child or Conclusion: The overall perception of women regarding gestational diabetes mellitus and its impact on their future generations

Factors Influencing Domestic Human Trafficking in Africa: Protocol for a Scoping Review.

Human trafficking is a human rights violation in every region of the world. The African continent is not spared. Every year, millions of people experience significant health and social consequences. International organizations and governments combating human trafficking are hindered by a lack of knowledge about what factors influence domestic (within-country) human trafficking. This study aims to conduct a scoping review to collate and synthesize literature on factors influencing domestic trafficking in Africa. We will follow Arksey and O'Malley's framework to answer the question about reported influences on domestic human trafficking and their relative weight. The search strategy will explore PubMed, CINAHL, Web of Science, and Scopus. A total of 2 independent researchers will select quantitative, qualitative, or mixed methods studies that examine relationships influencing domestic human trafficking. We will document our results by following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We will extract a list of all reported relationships between identified factors influencing domestic human trafficking in each study. Based on a discourse analysis approach, we will weigh the strengths of the relationships based on how frequently they are reported across the included studies. We will summarize the findings as fuzzy cognitive maps depicting the relationships reported in the literature. The maps represent the influences between concepts (nodes) linked by arrows (edges) going from each cause to its outcomes. These maps are helpful visual summaries of the factors associated with domestic human trafficking, allowing a comparison with maps to be created by stakeholder groups. This project received financial support in March 2023. We expect to start the project in March 2024. We recruited 2 research staff members to conduct the scoping review and expect to publish the results in March 2025. The review will provide a comprehensive understanding of factors influencing domestic human trafficking in Africa. The overlap of human trafficking with other forms of exploitation, the limited literature on domestic human trafficking, and the likely diversity of factors are challenges for the review. We propose strategies to address these challenges. PRR1-10.2196/56392.

Socioecological drivers of burnout - a mixed methods study of military health providers.

Health provider burnout is highly prevalent (28-51%) in the US and may contribute to a projected national health provider shortage by 2030. The Socioecological Model (SEM) is a proven conceptual framework used to identify influencing factors and design relevant solutions to improve health outcomes across multiple ecological levels. This study applied the SEM to identify modifiable drivers and solutions of burnout across multiple levels among US Military health providers. We conducted a cross-sectional mixed methods study using an online survey (N = 129) and in-depth interviews (N = 25) of active duty military health providers. Our primary quantitative outcome was self-reported definite, unrelenting, or complete burnout. Our quantitative analysis included chi-square tests of association and bootstrapped multivariable logistic regressions to explore SEM-informed correlates of burnout, controlling for contextual variables. Our qualitative data explored providers individual experience with workplace stress and burnout, providing details on factors influencing burnout at the individual, interpersonal, organizational and military levels. The qualitative data was systematically coded and analyzed using grounded theory. About two-thirds (63%) of surveyed providers self-reported burnout. Individual-level factors significantly associated with burnout included a positive coping style (AOR = 0.21; 95% CI: 0.08-0.56), perceived control over workload (AOR = 0.17; 95% CI: 0.04-0.66), and satisfaction with the current job (AOR = 0.11; 95% CI: 0.03-0.39). At the organizational level, providers described as overworked (AOR = 10.58; 95% CI: 3.30-33.91) or in hectic or chaotic primary work areas (AOR = 7.54; 95% CI: 2.33-24.38) had higher rates of burnout. At the military level, providers who were happy with their career path and promotion plan (AOR = 0.16; 95% CI: 0.06-0.44) reported lower rates of burnout. The organizational level had the highest cumulative impact of modifiable factors on burnout (AOR: 0.15; 95% CI: 0.06, 0.36). Qualitative interviews corroborated survey findings and highlighted the individual level manifestations of burnout, the role of interpersonal support as mitigators of burnout and the complexity of governmental and military policies impacting provider wellness. Identified factors influencing burnout at various levels may inform potential data-driven interventions to ensure a functional and vibrant US Military health. Data-driven strategies may include opportunities to balance work demands with resources and ability to cope as well as improve positive coping skills, attitudes and experiences related to work.

Reducing stigma and improving access to care for people with mental health conditions in the community: protocol for a multi-site feasibility intervention study (Indigo-Local)

BackgroundStigma and discrimination towards people with mental health conditions by their communities are common worldwide. This can result in a range of negative outcomes for affected persons, including poor access to health care. However, evidence is still patchy from low- and middle-income countries (LMICs) on affordable, community-based interventions to reduce mental health-related stigma and to improve access to mental health care.MethodsThis study aims to conduct a feasibility (proof-of-principle) pilot study that involves developing, implementing and evaluating a community-based, multi-component, awareness-raising intervention (titled Indigo-Local), designed to reduce stigma and discrimination and to increase referrals of people with mental health conditions for assessment and treatment. It is being piloted in seven sites in five LMICs—China, Ethiopia, India, Nepal and Tunisia—and includes several key components: a stakeholder group workshop; a stepped training programme (using a ‘Training of Trainers’ approach) of community health workers (or similar cadres of workers) and service users that includes repeated supervision and booster sessions; community engagement activities; and a media campaign. Social contact and service user involvement are instrumental to all components. The intervention is being evaluated through a mixed-methods pre-post study design that involves quantitative assessment of stigma outcomes measuring knowledge, attitudes and (discriminatory) behaviour; quantitative evaluation of mental health service utilization rates (optional, where feasible in sites); qualitative exploration of the potential effectiveness and impact of the Indigo-Local intervention; a process evaluation; implementation evaluation; and an evaluation of implementation costs.DiscussionThe output of this study will be a contextually adapted, evidence-based intervention to reduce mental health-related stigma in local communities in five LMICs to achieve improved access to healthcare. We will have replicable models of how to involve people with lived experience as an integral part of the intervention and will produce knowledge of how intervention content and implementation strategies vary across settings. The intervention and its delivery will be refined to be feasible and ready for larger-scale implementation and evaluation. This study thereby has the potential to make an important contribution to the evidence base on what works to reduce mental health-related stigma and discrimination and improve access to health care.

Physicians' inclination towards standard guidelines and regulations on incentive based prescribing practices in Karachi. A mixed methods study design.

To investigate private General Practitioners' (GPs) interest in continuous professional development (CPD), with a focus on ethical practices. A mixed method study design conducted a cross-sectional survey of registered private GPs (n=419) in Karachi was conducted in the year 2022 on their professional and ethical practices with perspectives on engagement in training in the year 2022. Qualitative interviews were conducted with 28 GPs to get a deeper understanding of their views on professional development. The median age of participants was 55 years (IQR 48-63 years) and 361 (86.2%) were males. The median number of years of professional experience was 31.0 years (IQR 24-37 years). It was observed that 116 (27.6%) of GPs saw more than 50 patients per day, and 377 (90%) met with pharmaceutical sales representative (PSR) regularly. Reported awareness of guidelines on ethical practices was 325 (77.6.0%), and willingness to sign a pledge committing to a code of ethics and to be part of a professional network of ethical doctors was high, 389 (~93.0%). However, both qualitative and quantitative data indicated that GPs had limited time for training, despite the interest in filling gaps in knowledge about ethical practice. Most GPs were willing to engage in CPD activities with a focus on ethics. Many GPs met regularly with PSRs, and CPD may reduce the pharmaceutical industry influence on their prescribing practices.

Perception About One Minute Perceptorship In Postgraduate Training of Ophthalmology

Objective: To evaluate the perception of postgraduate trainees of ophthalmology about One Minute Preceptorship. Study Design: Mixed method study Place and Duration of Study: Department of Ophthalmology Peshawar Medical College, Peshawar from Jun 2020 to Dec 2020. Methodology: Ten post graduate FCPS trainees of Ophthalmology were included in this study. The participants were introduced to and practiced One Minute Preceptorship for a period of 01 month in the outpatient clinic. A questionnaire for study was filled anonymously after taking an informed consent, which included ten closed ended and three open ended questions to assess the efficacy of One Minute Preceptorship model in improving practical skills like focused history taking, case presentation, clinical diagnosis and devising an effective management plan. Results: One Minute Preceptorship model is an effective learning and teaching tool for improving case presentation skills (90%), identifying disease presentation (70 %), clinical diagnosis (60%), identification of risk factors (80%) and understanding the management plan (70%).Qualitative analysis of One Minute Preceptorship model usage showed improved clinical evaluation skills, more efficient time consumption, prompt clinical diagnosis and provision of self-reflection to the learner. Conclusion: OMP model can be employed as an effective learning and teaching tool in an outpatient clinical setting in postgraduate Ophthalmology training.

Factors affecting enrollment of children with disabilities in child care and early education programs: A mixed methods study of Arkansas center-based programs

Children with disabilities experience various barriers to accessing child care and early education despite federal legislation that supports their inclusion in early care programs. This secondary analysis of mixed methods data explores factors that influence enrollment of children with disabilities from the perspective of licensed, center-based early childhood providers in Arkansas. Using survey data from 463 providers, we examined features of centers and their communities associated with child care and early education access for children with disabilities in Arkansas, finding that various features were related to serving and not serving children with disabilities. Additionally, we conducted a thematic analysis of interviews with 35 providers, finding that disability diagnosis, state and program policies, demand, confidence in staff and access to training, and referrals were important to providers’ decision-making process of enrolling children with disabilities. Integrated quantitative and qualitative results have implications for state policies that could increase enrollment of children with disabilities into early childhood programs.

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

BackgroundAs the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy.MethodsFor objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool.ConclusionsA PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

Integration of palliative rehabilitation in cancer care: a multinational mixed method study

BackgroundIncurable cancer is a major contributor to societal suffering and disability, and palliative rehabilitation is recommended to be integrated within and between cancer services at all healthcare levels. However, little knowledge exists on how integration of palliative rehabilitation in cancer is understood and achieved in clinical practice. INSPIRE (Integrated short-term palliative rehabilitation to improve quality of life and equitable care access in incurable cancer) is a large European-funded project that aims to promote quality of life through a novel rehabilitation model for people disabled by advanced cancer.AimTo compare the existing integration of palliative rehabilitation in cancer within official documents and in clinical practice across five European countries including United Kingdom, France, Denmark, Norway, and Italy.MethodsMixed methods study with a concurrent research design, comprising a document analysis (N = 23), stakeholder interviews (N = 22), and an online survey (N = 225). Data from each sub-study were analysed separately before results were merged.ResultsThere was limited integration of palliative rehabilitation in cancer in official documents and in clinical practice, though some indicators of integration, including participation in multidisciplinary teams and adherence to standardised pathways, were identified in the survey. Notably, integration of palliative rehabilitation in cancer in clinical practice was observed within limited organisations in secondary healthcare systems, without widespread adoption. Although palliative rehabilitation in cancer as a concept was sparingly used by stakeholders, they recognised the need for a comprehensive approach including multidisciplinary teams that aligns with the individual patient’s needs and goals. Moreover, the ambiguous distinction between the terms ‘palliative rehabilitation’ and ‘palliative care’, insufficient funding, lack of well-defined care pathways and competence gaps among healthcare professionals represented barriers to integration of palliative rehabilitation in cancer into clinical practice.ConclusionIntegration of palliative rehabilitation in cancer was limited in the five EU partnership countries investigated. Clarifying the concept of palliative rehabilitation, including adoption of the concept into official documents and delineating it from palliative care, is essential for more successful integration. This can possibly be achieved by addressing the barriers identified and fostering close collaboration across disciplines.

Conglomeration, Digital Disruption, and COVID-19: Upheaval-Driven Changes to the Roles of U.S. Local Television News Directors

This mixed methods study analyzes how broadcast news directors renegotiate their roles under organizational and cultural times of change. Even before COVID-19, local television news directors, one of the two predominant groups of journalism managers in the United States, were experiencing shifts in roles related to their growing work responsibilities. These changes were the result of long-term workplace upheavals including conglomeration and digital disruption. When the COVID-19 pandemic hit, news directors found themselves managing through this additional, short-term upheaval. The authors of this study sought to discover how industry upheavals impact broadcast newsroom management roles.

Design Guidelines for Improving Mobile Sensing Data Collection: Prospective Mixed Methods Study.

Machine learning models often use passively recorded sensor data streams as inputs to train machine learning models that predict outcomes captured through ecological momentary assessments (EMA). Despite the growth of mobile data collection, challenges in obtaining proper authorization to send notifications, receive background events, and perform background tasks persist. We investigated challenges faced by mobile sensing apps in real-world settings in order to develop design guidelines. For active data, we compared 2 prompting strategies: setup prompting, where the app requests authorization during its initial run, and contextual prompting, where authorization is requested when an event or notification occurs. Additionally, we evaluated 2 passive data collection paradigms: collection during scheduled background tasks and persistent reminders that trigger passive data collection. We investigated the following research questions (RQs): (RQ1) how do setup prompting and contextual prompting affect scheduled notification delivery and the response rate of notification-initiated EMA? (RQ2) Which authorization paradigm, setup or contextual prompting, is more successful in leading users to grant authorization to receive background events? and (RQ3) Which polling-based method, persistent reminders or scheduled background tasks, completes more background sessions? We developed mobile sensing apps for iOS and Android devices and tested them through a 30-day user study asking college students (n=145) about their stress levels. Participants responded to a daily EMA question to test active data collection. The sensing apps collected background location events, polled for passive data with persistent reminders, and scheduled background tasks to test passive data collection. For RQ1, setup and contextual prompting yielded no significant difference (ANOVA F1,144=0.0227; P=.88) in EMA compliance, with an average of 23.4 (SD 7.36) out of 30 assessments completed. However, qualitative analysis revealed that contextual prompting on iOS devices resulted in inconsistent notification deliveries. For RQ2, contextual prompting for background events was 55.5% (χ21=4.4; P=.04) more effective in gaining authorization. For RQ3, users demonstrated resistance to installing the persistent reminder, but when installed, the persistent reminder performed 226.5% more background sessions than traditional background tasks. We developed design guidelines for improving mobile sensing on consumer mobile devices based on our qualitative and quantitative results. Our qualitative results demonstrated that contextual prompts on iOS devices resulted in inconsistent notification deliveries, unlike setup prompting on Android devices. We therefore recommend using setup prompting for EMA when possible. We found that contextual prompting is more efficient for authorizing background events. We therefore recommend using contextual prompting for passive sensing. Finally, we conclude that developing a persistent reminder and requiring participants to install it provides an additional way to poll for sensor and user data and could improve data collection to support adaptive interventions powered by machine learning.

A Scoping Review of Episodes of Lucidity in People Living With Dementia Near the End of Life: The Potential Role of Speech-Language Pathology in Research and Practice

Purpose: Emerging evidence suggests that people with dementia may experience episodes of lucidity (ELs) near the end of life, characterized by a temporary recovery of function, communication abilities, and/or awareness of surroundings. This scoping review aims to identify the available evidence on EL, clarify its key concepts and characteristics, identify knowledge gaps, describe the disciplines involved in EL research, and provide recommendations for speech-language pathologists (SLPs) working with people with dementia at the end of life. The ultimate goal is to guide future research and develop clinical strategies for SLPs involved in end-of-life care for this population. Method: A scoping review was conducted with a systematic literature search across five major databases using relevant terms such as “dementia,” “end-of-life,” and “lucidity,” covering all records up to May 2023. The review included quantitative, qualitative, and mixed-methods studies focused on lucid episodes at the end of life. Results: Of 5,780 articles screened by two independent reviewers, 10 met the criteria and were synthesized using narrative methods. Data extraction and quality assessment were independently performed by these reviewers. Among the selected studies, three were case reports, while the remaining seven employed qualitative assessments based on caregiver or informant reports. Most studies involved disciplines such as nursing, medicine, and psychology. All definitions and reports of lucidity involved aspects of verbal and nonverbal communication by individuals living with dementia. Conclusions: The scoping review provides a valuable synthesis of evidence on lucid episodes in people with severe dementia near the end of life, highlighting an area of growing research interest. Exploring the neurobiological and behavioral aspects of lucidity in dementia can lead to enhanced care for older adults. Given the fundamental role of communication in defining lucidity, SLPs are well positioned to contribute to this research and care continuum.

Supplemental Material for The Worst of Times: Using a Transformative Mixed-Methods Study to Name and Describe School-Based Adverse Racialized Experiences (AREs) in the K–12 Retrospective Accounts of University Students

Supplemental Material for The Worst of Times: Using a Transformative Mixed-Methods Study to Name and Describe School-Based Adverse Racialized Experiences (AREs) in the K–12 Retrospective Accounts of University Students

Universally Designed Virtual Reality: Creating Inclusive and Immersive Learning Experiences with 'VRinDanger'.

This paper presents the design and implementation of VRinDanger, a universally designed (UD) educational virtual reality (VR) application aimed at providing an inclusive and immersive learning experience focused on the world's deadliest animals. A mixed-methods study involving participants with diverse ages, skills, and abilities was conducted to evaluate the application's accessibility, usability, user experience, and educational effectiveness in terms of learning outcomes. The findings demonstrate that integrating UD principles into VR design significantly improves accessibility, enhances user satisfaction, and promotes engagement and retention of educational content for diverse audiences. Furthermore, the study highlights the need for cost-effective, cross-platform VR solutions and the development of VR-specific accessibility guidelines. These insights contribute to the advancement of inclusive VR design and its broader application in educational technology.

The Resilience and Lived Experiences of the Parents of Children With Autism in India: A Mixed-method Study

Background and Objectives: Families dealing with autism spectrum disorder (ASD) children try to adapt with different strategies. 1) To assess the resilience of parents dealing with children having ASD and its associated factors. 2) To explore the perspective and strategies of families dealing with children having ASD Methods: This was a mixed-methods study done over a period of 3 months among parents having children diagnosed with ASD; undergoing institutional therapy for more than 6 months in duration. Data collection was done using the PREQ questionnaire and key informant interviews (KII). Informed consent was taken prior to each interview and audio recordings. Relevant tests of significance and deductive analysis followed. Results: There was an equal divide observed between the low (50%) and high resilience (50%) groups. Binary logistic regression showed that the upper socio-economic class showed higher odds of better resilience (OR=4.038, 95% CI, 2.857%, 4.894%) as compared to the lower socio-economic class, and those with higher levels of education showed better resilience (OR=9.903, 95% CI, 2.502%, 3.483% than the lesser educated. KII explored different perspectives on personal experiences, concerns, challenges, attitudes, etc. where both perspectives such as benefits and hardships were addressed on an individual as well as a family basis, respectively Conclusion: Education and socio-economic backgrounds played a role in mending the resilience and other active measures such as peer support mechanisms and self-coping strategies also influenced the attitude and improved determination of parents dealing with children having ASD.

Workplace violence against medical students during clinical practice and its relevant factors: a mixed methods study

ABSTRACT Our study aims to describe the status of workplace violence against medical students during clinical practice, which consists of its prevalence, types, perpetrators, students’ responses and influences on them, reasons for workplace violence and to determine some relevant factors of this issue through both quantitative questionnaire and qualitative interview. A descriptive cross-sectional study with mixed methods was conducted on 320 students from the second-year to the sixth-year classes at Hanoi Medical University from August 2022 to February 2023. The questionnaire was based on the WHO questionnaire survey ‘Workplace violence in the health sector – country case studies research instruments – Geneva 2003’. 10 students from quantitative research who completed the questionnaire, experienced at least one type of workplace violence and consented to continue taking part in the research were chosen for in-depth interviews. The prevalence of students witnessing and/or experiencing workplace violence was 35.6% and 19.4% of the sample population had experienced at least one kind of workplace violence. Medical staff were the most common perpetrators. 86.8% of students who were exposed to workplace violence did not report the incidents for a variety of reasons. The major reasons leading to workplace violence related to patients, patients’ relatives and students, among which the first-ranked ones were the patients’ education level and their unsatisfied expectations. Some relevant factors to workplace violence against medical students were determined by quantitative analysis such as students’ grade (OR = 3.09) and region (OR = 3.31) and were explored additionally by qualitative interview such as the student management of the instructors, students’ personality, attitude and appearance as well as hospital environment. Based on the research findings, establishing prevention methods, which require action from both individuals (students, medical staff) and organizations (universities, hospitals) is recommended.

The Promotion of Non-Communicable Disease Screening in Gurage Zone, Ethiopia: A Mixed-Method Study.

Despite the high non-communicable disease (NCD) mortality in Ethiopia, NCD screening in the country remains suboptimal. This study assessed the health communication process and materials designed to promote NCD screening among adult primary healthcare facility attendants in the Gurage Zone, Ethiopia. A parallel mixed-methods approach was employed. Seven health communication materials were evaluated using the Modified Clear Communication Index Score by the Center for Disease Control and Prevention (CDC). Seven key informants who were involved in the production were interviewed to explore the process. Users' satisfaction with the materials was assessed through a cross-sectional survey (N = 412). We used multivariable logistic regression with SPSS version 27 software to determine the factors associated with users' satisfaction. Thematic analysis was applied for the qualitative data analysis using Opencode 4.03 software. Qualitative interviews indicated that the production process relied on evidence, involved stakeholders, and included pretesting. The CDC index score revealed that five of the seven materials were considered clear and user-friendly, whereas two required improvement. Overall users' satisfaction with the material was high with a mean score of 22.10 (SD ± 2.34; min: 14, max: 25). Age and educational status had significant positive association with users' satisfaction. Developing health communication materials on promoting NCD screening based on evidence, stakeholders' input, and pretesting can lead to good quality material and user satisfaction. We recommend future research works to measure changes in NCD screening service uptake as a result of using the health communication materials considered in this study.

The Usability of Hip Protectors: A Mixed-Method Study from the Perspectives of Singapore Nursing Home Care Staff

The EXO+ hip protector was developed to minimize the risk of hip fractures in seniors following falls. This study evaluated its usability in a Singapore nursing home from the perspective of the staff, focusing on learnability, efficiency, and satisfaction. A mixed-method design was employed, with nursing home residents wearing the EXO+ daily for eight weeks. Quantitative data on wear time were collected alongside qualitative insights from four repeated focus group discussions with care staff. In total, 15 residents (including 8 residents with cognitive impairments) and 9 staff participated. The analysis revealed six themes and fourteen subthemes related to EXO+’s usability. The residents wore the device for an average of 1.54 h per day, with those having cognitive impairments showing increased wear times, especially in the mornings and on weekdays. The findings indicated that the EXO+ was learnable and satisfactory for nursing home use, provided there are adequate supporting features. The efficiency of the EXO+ was not fully measured since no falls were reported during the study period. The study offers valuable insights for potential design modifications and workflow adaptations to enhance the implementation of hip protectors in healthcare settings, highlighting facilitators and barriers to support device uptake.

Social Interactions Among Undergraduates at State Universities: An Analysis of Experiences Post-Easter Sunday Terrorist Attacks

Sri Lanka is a country with diverse religions and ethnicities. Sri Lanka’s Muslim-Buddhist relationship dates back centuries. Its diverse background is due to its long history of religions, cultures, and ethnic groups. Because of tension and enmity between different ethnic groups, ethnic conflict is frequent. Exactly this happened with the Easter Sunday bombings on 21 April 2019. The main objective of this study is to examine whether the criticism and hate speech that occurred after the Eastern Sunday attack affected the social interaction of university students. The researchers used a mixed method of study through an empirical approach. The data for the study were collected by distribution of 268 questionnaires and 25 unstructured interviews. The questionnaire data were analysed with the help of SPSS software (version 26); interview transcriptions underwent a coding analysis method. According to the findings, There was a healthy social interaction between the undergraduates of the two religions. Nevertheless, factors that hinder mutual contact include frequent meetings with the same religious students and being threatened by one's religious friends when developing good relations with a person belonging to another religion. Several parameters need to be met for a healthy social co-existence to be built on mutual understanding, including a lack of understanding of other religious beliefs and a lack of interest in learning other recipes. It is likely that if this situation continues in the future, tensions will arise between Muslims and other students at the university.

Integrating Pop Music in English Language Teaching to Enhance Listening, Vocabulary, and Cultural Awareness Among Learners

This study explores the efficacy of using popular music as a pedagogical tool in English language classrooms. Drawing from linguistic theory and empirical evidence, the study examines how integrating pop songs can enhance students' listening skills, vocabulary acquisition, pronunciation, and cultural awareness. Through a mixed-methods approach, including surveys, observational studies, and comparative analysis, we evaluate the impact of pop music on language retention and learner engagement. Findings suggest that students who engage with music show improved comprehension and increased motivation in language learning.