Mixed Research Study Research Articles

Computational thinking with game design: An action research study with middle school students

AbstractMiddle school students often enter Computer Science (CS) classes without previous CS or Computational Thinking (CT) instruction. This study evaluated how Code.org’s block-based programming curriculum affects middle school students’ CT skills and attitudes toward CT and CS. Sixteen students participated in the study. This was a mixed methods action research study that used pre- and post-tests, surveys, artifacts, and interviews as data sources. Descriptive statistics, paired samples t-tests, and inductive thematic analysis were administered. Findings showed a statistically significant increase in participants’ algorithmic thinking, debugging, and pattern recognition skills but not in abstraction skills. Attitudes toward CT and CS improved but the difference was not statistically significant. Qualitative themes revealed benefits of game-based learning to promote CT skills, collaboration to promote successful error debugging, and enjoyment of programming resulting from a balance between structured guidance and creative freedom. Findings emphasize the importance of low-threshold and engaging strategies to introduce novice learners to CT and CS.

Lessening the energy usage of buildings: An exploration into green walls practicalitie

The article provides insights into green walls’ potential and energy-saving mechanisms in Melbourne, Australia. The use of vegetation on a building’s façade has been shown to positively affect the building’s demand for heating and cooling and a range of additional benefits. A mixed research study has been developed to explore and quantify using vegetated facades as a feasible option for reducing energy usage in commercial buildings. These results show that a green wall of building construction holds a similar level of thermal resistance as a 2.5cm layer of expanded polystyrene building insulation, at an R-value of 0.38m2 K/W. Combining this calculation with speculations as to the benefits of shade, evapotranspiration, and wind production has produced data showing a typical green wall can reduce the energy usage of a commercial building by up to 12%. This figure supports the use of vegetated façade systems to reduce energy usage in the built environment. This study can be instrumental in raising awareness for building and property professionals, as well as occupants, of the positive effects of green (vegetated) walls on the façades of buildings as a viable option for reducing heating and cooling loads and consequently, reducing spending on energy usage.

Enhancing learners’ sense of belonging in online threaded discussions

Many different factors influence students’ sense of belonging in an online learning. One area of the learning experience in which a sense of “belonging” is critical is in online asynchronous discussions, and the degree to which students feel that their contributions to those discussions are valued. Unfortunately, the structure of threaded discussions is inherently limiting. It restricts learner engagement by only allowing students to reply to an individual note. This hampers students’ ability to discuss relationships between ideas from multiple participants, hindering synthesis and comprehensive understanding. This mixed methods explanatory sequential design research study examines the use of an innovative linking tool that allows students to create a rich set of linkages between notes. Findings suggest that students appreciated the linking tool as it facilitated idea integration and enhanced the flow and organization of discussions. Notes containing links were more extensive, written at a higher level, and received more peer recognition than notes without links. The linking tool created more connected and less repetitive discussions, while also increasing the amount of recognition students received for their notes. Despite the additional effort required, students continued to create links, motivated by the tool’s ability to organize ideas and the social recognition received.

Implementation of perennial malaria chemoprevention in infants at district-level in Togo: mixed methods assessment of health system readiness

IntroductionIn June 2022, WHO recommended the administration of Perennial Malaria Chemoprevention (PMC) alongside Expanded Immunization Programmes for children under two years. We investigated the health systems readiness for PMC implementation in Togo. MethodAs part of the multi-country MULTIPLY project, we conducted a mixed methods implementation research study in the 27 health facilities of Haho district in Togo. All district health care providers (n=188) and a sample of community health workers (n=43) were invited to respond to a self-administered Knowledge-Attitudes-Practices questionnaire. Structured observations in 4 health facilities and 19 semi-structured interviews were conducted. Descriptive analysis was conducted on quantitative data. Qualitative data was analysed thematically, using an inductive approach. We report here on the implementation context for PMC, its infrastructural feasibility and its acceptability among health care workers (HCWs). ResultsOverall, respondents perceived PMC as relevant in the context of high malaria burden and had a good knowledge about malaria and its prevention. HCWs foresaw good community acceptability of PMC. Although some HCWs did not understand the rationale of PMC if children are not sick, they also believed PMC would be effective, in line with their perceptions of preventive malaria treatment during pregnancy. Several challenges were foreseen such as distance barriers for accessing health facilities, difficulties in accessing drinking water, supplies for PMC administration, or lack of dedicated health workforce and area for PMC administration. ConclusionAt district-level in Togo, overall pre-intervention acceptability of PMC was encouraging. Structural and operational challenges were identified as possible barriers to implementation feasibility.

Soft skills in the tourism industry of the future: a comparison between Italy and Spain

PurposeThe harmonisation of university degrees at the European level leads us to believe that training needs are addressed in the same way in different countries. However, the inevitable adaptation to the changing environment faced by companies requires a continuous adjustment between training and future needs, according to the sector. The aim of this paper is to compare two leading and culturally similar countries in the tourism sector in order to determine whether training is being provided homogeneously in tourism higher education and whether more specific training is desired to meet the needs of the sector in each country.Design/methodology/approachThis study is part of the European Next Tourism Generation (NTG) Project, the first European partnership to foster a collaborative and productive relationship between the education system and the tourism industry. A mixed research study was conducted with the purpose of development, i.e. with the intention that the results of one method (qualitative) are used to assist the development of the other method (quantitative) and an exploratory sequential design. Both qualitative (29 interviews) and quantitative (509 tourism organisations) methods are used.FindingsFor a sector that has undergone significant changes in recent years, the results show the differences between countries around the current level of soft skills of employees, the level they will need to develop in the future and the gaps that those responsible for training future employees in the sector need to focus on for the 2030 horizon.Practical implicationsSeveral recommendations have emerged from this paper: to complement higher education, to achieve a better link between the business world and future workers; to provide much more incentives for international student mobility, which will allow students to develop intercultural soft skills before they enter the world of work, and to propose the creation of a social network to share, communicate and learn about resources specific to the tourism industry.Originality/valueSince the Bologna Plan, higher education institutions have been tasked with preparing students for the world of work and developing the employability of graduates. The link between the professional world (companies) and the educational world (training centres) is a crucial factor in determining students' future skills and needs. When educational programmes respond to the needs of industry, the university can gain a competitive advantage. Therefore, some authors suggest the need for coordination and regular communication between business and training centres, thus improving the competitiveness of companies and reducing the gap that currently exists. In this paper, comparing two culturally similar countries with a recognised trajectory in the tourism sector, we will try to observe this gap and propose interesting options for the future of the sector.

Classroom to escape room: an innovative experience to prepare and test students

Paramedicine is a rapidly evolving profession and teaching strategies need to be creative and forward thinking to meet the ever-changing demands of the role. Educational escape rooms incorporate a variety of learning environments in which students participate in a range of simulation-based activities based on solving puzzles and retrieving codes, which result in finding a prize. A mixed methods action research study was undertaken to ascertain whether an escape room approach can increase engagement and attainment in year-one paramedic science degree students at a UK university. The results showed that 100% (n=52) stated they would recommend this activity, 100% (n=52) agreed it helped them to review their teamwork skills and 98% (n=51) said that it improved their communication techniques. Non-technical skills enable the development of technical skills and knowledge within the workplace and are an overarching factor in providing good practice and reducing errors. An escape room approach is arguably an effective teaching method when the activities are based on learning outcomes.

Impact of the COVID‐19 pandemic on enrollment at United States Alzheimer’s Disease Research Centers

AbstractBackgroundImpacts of the COVID‐19 pandemic have been disproportionate by race/ethnicity and sex. We aimed to characterize the impact of the pandemic on enrollment in US Alzheimer’s Disease Research Centers (ADRCs) overall and by race/ethnicity and sex using National Alzheimer’s Coordinating Center (NACC) data.MethodsWe included data on N = 8875 participants (mean age, 69.4 years; 59% female; 9% Hispanic/Latino; 14% Black/African American) from 29 ADRCs with ≥5 years of data and study visits after 2020 (e.g., baseline visits from January 2017‐December 2021). We used interrupted time series (ITS) analyses to assess the relationship of the pandemic on enrollment and calculated projected date of recovery of pre‐pandemic enrollment overall and by race, ethnicity, and sex.ResultsEnrollment dropped to 0% of pre‐pandemic levels in April 2020; through December 2021, enrollment recovered to only 46% of pre‐pandemic levels. Participants enrolled during the pandemic (vs pre‐pandemic) were less likely to be: women, cognitively normal, and able to live independently. They were slightly younger, slightly more educated, and more likely to: be married, be referred by a doctor, nurse, or other professional, and come in for a clinical or mixed clinical and research study evaluation (p’s<0.05). The two groups did not vary by race, ethnicity, living situation (alone or with others), or co‐participant characteristics. ITS demonstrated that the pandemic caused an immediate 79% drop in enrollment rate, with an estimated post‐pandemic increase in enrollment of 0.92%/month, leading to a projected recovery date of January 2026. Due to parallel pre‐ and post‐pandemic enrollment slopes among Black/African American participants, we could not predict a recovery date for this group. Projected recovery varied by ethnicity with Hispanic participant enrollment recovering earlier than non‐Hispanic participant enrollment (January 2022 vs. April 2027), largely because Hispanic participant enrollment was declining nearly 1.5%/month pre‐pandemic. Recovery date projections also varied by sex, with female participant enrollment recovering sooner than male participant enrollment (June 2025 vs. May 2027).ConclusionsStrategies to speed enrollment recovery should be developed and implemented, with special attention given to Black/African American and Hispanic enrollment. Funders and researchers should be aware of and account for ongoing COVID‐19 impact on ADRD research enrollment.

Key stakeholders' perspectives: A gap analysis of hospital-acquired pressure injuries.

Hospital-acquired pressure injuries (HAPIs) are a global high-stakes patient safety issue. Key stakeholder perspectives regarding their role and experiences with pressure injuries is critical as part of the solution to minimizing HAPI occurrence and attain sustainability. A qualitative, descriptive approach provided multiple perspectives of key stakeholders to support the complexity of HAPI care. The qualitative data are a part of a mixed method convergent research study examining pressure injury prevention and management practices. Nursing system theory, mixed method convergent design, and participatory action research methodologies were chosen to address both the gap analysis development and results, achieve collaborative comprehensiveness, and enable key stakeholder involvement throughout this HAPI prevention and management initiative. Participants were recruited and enrolled from a large Level I trauma hospital and the key stakeholders. Demographic information were collected prior to the individual interview. Focused interviews were conducted virtually using zoom technology. Qualitative data were analyzed using NVivo software and thematic analysis was confirmed across the co-investigators for congruence and applicability to the research questions. Qualitative interviews with 26 key stakeholders provided data to support and integrate a link with gap analysis results on the complex health issue of HAPIs. Specific barrier and recommendation themes identified interventions that could be prioritized. The 52 barrier and 52 recommendation themes/sub-theme(s) respectively were organized by Donabedian (structure, process, and outcome) with structure elements the majority. The top three structure barrier themes involved equipment and standards for use, staff prevention education, and specialized health professionals. The top three structure recommendation themes involved specialized health professionals, equipment and standards for use, and an educational plan for those at risk or with HAPIs. The article provides findings from the qualitative portion of a mixed method study related to HAPIs. The qualitative findings associated with the gap analysis quantitative results, achieved the goal of the participatory action research key stakeholders' input into HAPI care and can be replicated internationally. The benefit of key stakeholder's involvement in solving a clinical problem is sustainability. A quantitative approach and integrating qualitative stakeholders' perspectives provide an in-depth solution that will advance nursing capacity toward health care delivery and HAPI nursing science and policy development on a global level.

Early implementation learnings on acceptability and feasibility of “V”: a multi-level PrEP intervention designed with and for adolescent girls and young women in Zimbabwe

IntroductionAdolescent girls and young women (AGYW) remain disproportionately affected by HIV in Zimbabwe. Several HIV prevention options are available, including oral tenofovir-based pre‐exposure prophylaxis (PrEP), however AGYW face unique barriers to PrEP uptake and continuation and novel approaches are therefore needed to empower AGYW to use PrEP. The objective of this study was to characterize early learnings from implementing a multi-level intervention consisting of fashionable branding (including a “V Starter Kit”), service integration, and peer education and support throughout a young woman's journey using oral PrEP across four phases of implementation, from creating demand, preparing for PrEP, initiation of PrEP, and adherence to PrEP.MethodsA mixed methods implementation research study was undertaken, including site observations and interviews to explore the acceptability of “V” and its relevance to target users, as well as the feasibility of integrating “V” with existing service delivery models. Interviews (n = 46) were conducted with healthcare workers, Brand Ambassadors, and young women purposively sampled from four implementation sites. Interview data was analyzed thematically using the framework method for qualitative data management and analysis. Project budgets and invoices were used to compile unit cost and procurement data for all “V” materials.Results“V” was acceptable to providers and young women due to attractive branding coupled with factual and thought-provoking messaging, establishing “a girl code” for discussing PrEP, and addressing a gap in communications materials. “V” was also feasible to integrate into routine service provision and outreach, alongside other services targeting AGYW. Cost for the “V” branded materials ranked most essential—FAQ insert, pill case, makeup bag, reminder sticker—were $7.61 per AGYW initiated on PrEP.Conclusion“V” is a novel approach that is an acceptable and feasible multi-level intervention to improve PrEP access, uptake, and continuation among AGYW, which works through empowering AGYW to take control of their HIV prevention needs. In considering “V” for scale up in Zimbabwe, higher volume procurement and a customized lighter package of “V” materials, while still retaining V’s core approach, should be explored.

Rehabilitation needs of people with brain tumours in Ireland: Protocol for a prospective, mixed methods action research study ("Brain-RESTORE").

Background: Approximately 480 people annually in Ireland are diagnosed with a primary brain tumour. Brain tumours are a heterogeneous group of conditions, varying in histopathology, location, and progression. A consistent feature is neurological impairment, which can lead to profound effects on physical and cognitive function. There is evidence that people with brain tumours can benefit from rehabilitation, but pathways are poorly described, and no best practice is defined. This leads to significant unmet need. The aim of this study is to understand the rehabilitation needs of people diagnosed with a brain tumour in Ireland, and gain insight to inform policy and practice. Methods: A prospective, mixed methods study with embedded action research will be conducted. Patients (n=122) with a new diagnosis of primary brain tumour, and optionally, a nominated carer or family member, will be recruited through a national neuro-oncology service. Rehabilitation need (Mayo-Portland Adaptability Inventory), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Brain Cancer Module, EuroQol-5D-5L), healthcare utilisation and, optionally, carer needs (Carer Support Needs Assessment Tool) will be assessed at four, eight and 12 months post diagnosis. An embedded qualitative study will invite 30 patients and carers to a semi-structured interview to explore their lived experience of rehabilitation needs and services following brain tumour diagnosis. Finally, using an Action Research approach, healthcare professionals involved in caring for people with brain tumours will be invited to participate in co-operative inquiry groups, to reflect on emerging aggregate findings and identify actions that could be undertaken while the study is underway. Conclusions: By understanding rehabilitation need, the findings will help healthcare professionals and health service providers understand how to prioritise the supports required and encourage policy makers to adequately resource neurorehabilitation to meet the needs of people with a brain tumour diagnosis.

Safe Care and Medication Intake Provided by Caregivers at Home: Reality Care Study Protocol.

Providing care to patients with several conditions and simultaneously taking several medications at home is inexorably growing in developed countries. This trend increases the chances of home caregivers experiencing diverse errors related with medication or care. To determine the effectiveness of four different educational solutions compared to the natural intervention (absence of intervention) to provide a safer care at home by caregivers. Prospective, parallel, and mixed research study with two phases. Candidates: Home-based caregivers caring a person with multiple comorbid conditions or polymedication who falls into one of the three profiles of patients defined for the study (oncology, cardiovascular, or pluripathological patients). First phase: Experts first answered an online survey, and then joined together to discuss the design and plan the content of educational solutions directed to caregivers including the identification of medication and home care errors, their causes, consequences, and risk factors. Second phase: The true experiment was performed using an inter- and intrasubject single-factor experimental design (five groups: four experimental groups against the natural intervention (control), with pre- and post-intervention and follow-up measures) with a simple random assignment, to determine the most effective educational solution (n = 350 participants). The participants will be trained on the educational solutions through 360 V, VR, web-based information, or psychoeducation. A group of professionals called the "Gold Standard" will be used to set a performance threshold for the caring or medication activities. The study will be carried out in primary care centers, hospitals, and caregivers' associations in the Valencian Community, Andalusia, Madrid, and Murcia. We expect to identify critical elements of risk management at home for caregivers and to find the most effective and optimal educational solution to reduce errors at home, increasing caregivers' motivation and self-efficacy whilst the impact of gender bias in this activity is reduced. Clinical Trial NCT05885334.

Design-Based Research as Professional Development: Outcomes of Teacher Participation in the Development of the Science Practices Innovation Notebook (SPIN)

ABSTRACT The use of data to explain natural phenomena has been a core feature of science education, and science educators continue to call for an increased emphasis on teaching data practices. This mixed methods design-based research study adds to the growing body of research on data practices in science by explaining the learning trends of science teachers involved in a three-year collaborative professional development (PD) using computational thinking (CT) and self-regulated learning (SRL) as a means to support teachers in implementing data practices. The PD resulted in long-term high-quality teacher learning outcomes for all three elements of the PD (data practices, CT, and SRL) despite the upheaval of teaching platforms due to the COVID-19 pandemic. Since the teachers were involved in design-based research, their professional learning focused on collaboratively creating an electronic, interactive notebook with lessons for use in science classrooms across the United States. Creating a common product as an outcome of the PD may have served as motivation for teachers to learn about and implement more data practices, CT, and SRL, which suggests that design-based research is another valuable design for teacher PD.

Troublesome Knowledge and Liminality in ELT Threshold Concepts: A mirror reflecting how knowledge is processed on the minds of students

Troublesome knowledge, being an essential characteristic of threshold concepts, emerges when university students find it too difficult to understand concepts. According to Perkins (2006), the causes of concepts becoming troublesome are when they are perceived ritual, inert, conceptually difficult, alien and/or tacit. As a result, students crossing a threshold concept go through the liminality of four modes of variation, which are preliminal, liminal, postliminal and subliminal (Land & Meyer, 2010; Meyer & Land, 2003, 2006a). Interestingly, investigating troublesome knowledge in tertiary disciplines reveals how students cognitively interact with concepts within the subject matter of a discipline. The aim of this paper, based on a mixed method EdD research study, is to focus on what concepts ELT Omani student teachers perceived as troublesome knowledge, how they processed troublesome knowledge and what types of strategies they used to overcome troublesome knowledge. The findings revealed a huge variety of different concepts that were perceived as troublesome knowledge. They also showed that the strategies of asking others to help, asking my teachers to help and reading more about the concepts were the three top strategies ELT Omani student teachers used.

Exploring Learning Loss in Mathematics for Lebanese Secondary School Students during Economic and Health Crisis

The purpose of this research is to explore the effect of school closure during the economic and health crises on the learning loss of mathematics concepts of secondary students in public and private schools in Lebanon. This mixed research study used concurrent exploratory design involving quantitative data collection through teachers’ questionnaires and qualitative through a comparison of the official examinations in mathematics and CERD documents before and after the crisis. Data analysis was conducted along descriptive and inferential statistics for the questionnaire while document analysis was used to compare suspended concepts between 2019-2022 as well as a thorough analysis of the official exams for grade 12 – General Sciences. A parallel study following the same methodology was implemented for biology. The results showed that there is a significant learning loss in mathematics content along the three targeted years. The official national exams analysis grounded on Bloom’s taxonomy showed a decline in quality. Based on the teachers’ perspectives, there is a discrepancy between learning loss in private and public schools as well as between different regions. The results of this study will inspire the policymakers to implement plans for remedy and holistic measures for mathematics learning loss.

Cloud Formation (IaC): Deploying a Containerized Application on Cloud

Abstract: This study is a literature review on cloud computing trends as one of the Fastest growing technologies in the computer industry and their benefits and opportunities for all types of organizations.In addition, it addresses the challenges and problems that contribute to increasing the number of customers willing to adopt and use the technology. A mixed research study approach was adopted for the study, that is by collecting and analysing both quantitative and qualitative information within the sane literature review and summarizing the findings of previous (related) studies. Results highlights the current and future trends of cloud computing and exposes readers to the challenges and problems associated with cloud computing. The reviewed literature showed literature showed that the technology is promising and is expected to grow in the future. Researchers have proposed many techniques to address the problems and challenges of cloud computing, such as security and privacy risks, through mobile cloud computing and cloud-computing governance.

Perceptions and Use of Telehealth Among Diverse Communities: Multisite Community-Engaged Mixed Methods Study.

Telehealth has been increasingly adopted by health care systems since the start of the COVID-19 pandemic. Although telehealth may provide convenience for patients and clinicians, there are several barriers to accessing it and using it effectively to provide high-quality patient care. This study was part of a larger multisite community-engaged study conducted to understand the impact of COVID-19 on diverse communities. The work described here explored the perceptions of and experience with telehealth use among diverse and underserved community members during COVID-19. We used mixed methods across three regions in the United States (Midwest, Arizona, and Florida) from January to November 2021. We promoted our study through social media and community partnerships, disseminating flyers in English and Spanish. We developed a moderator guide and conducted focus groups in English and Spanish, mostly using a videoconferencing platform. Participants were placed in focus groups with others who shared similar demographic attributes and geographic location. Focus groups were audio-recorded and transcribed. We analyzed our qualitative data using the framework analytic approach. We developed our broader survey using validated scales and with input from community and scientific leaders, which was then distributed through social media in both English and Spanish. We included a previously published questionnaire that had been used to assess perceptions about telehealth among patients with HIV. We analyzed our quantitative data using SAS software and standard statistical approaches. We examined the effect of region, age, ethnicity/race, and education on the use and perceptions of telehealth. We included data from 47 focus groups. Owing to our mode of dissemination, we were not able to calculate a response rate for the survey. However, we received 3447 English-language and 146 Spanish-language responses. Over 90% of participants had internet access and 94% had used telehealth. Approximately half of all participants agreed or strongly agreed that telehealth would be beneficial in the future because it better fit their schedules and they would not need to travel. However, approximately half of the participants also agreed or strongly agreed they would not be able to express themselves well and could not be examined when using telehealth. Indigenous participants were especially concerned about these issues when compared to other racial groups. This work describes findings from a mixed methods community-engaged research study about telehealth, including perceived benefits and concerns. Although participants enjoyed the benefits of telehealth (eg, not having to travel and easier scheduling), they also had concerns (eg, not being able to express themselves well and not having a physical exam) about telehealth. These sentiments were especially notable among the Indigenous population. Our work highlights the importance of fully understanding the impact of these novel health delivery modalities on the patient experience and actual or perceived quality of care received.

An Examination of Factors Determining User Privacy Perceptions of Voice-Based Assistants

Purpose: Voice-based assistants have become ubiquitous in our homes and all around us. We interact with voice-based assistants through smartphones, dedicated home devices, or other Internet-connected devices. The proliferation of these devices in our lives makes us question whether the data transmitted through these devices are secure and the role perception of privacy the users of these devices have in the usage of the device. This paper focuses on the user privacy issues specific to two voice-based assistants – Amazon Alexa and Google Assistant using quantitative and qualitative methods. The paper will answer three research questions regarding user privacy perceptions and how a user’s technology adoption, smartphone operating system, and demographics influence their perception of privacy. Study design/methodology/approach: This is a mixed research study where survey data was collected from faculty, staff, and students of a large University in the United States and professional connections globally. Findings: Privacy perceptions vary based on user age, educational level, gender, smartphone adoption, and technical awareness and expertise. Originality/value: This study is unique in highlighting the perception of privacy for voice-based assistants and assigning a numerical value based on survey data to the concern. Another feature of the study is its correlation of privacy perception with mobile phone operating systems and the level of technical expertise of voice-based assistant users.

The Outcome-Present State Test Model of Clinical Reasoning to Promote Critical Thinking in Psychiatric Nursing Practice among Nursing Students: A Mixed Research Study

In this interventional study, 19 students were taught critical thinking skills using the OPT clinical reasoning model during a psychiatry clinical practice. Work-learning forms were used in daily 1 h individual and group discussions with students. The critical thinking disposition scale was completed by every student before and after the intervention. Moreover, the students were asked to the complete reflection experience forms. The average critical thinking disposition pre-intervention score was 95.21, whereas the average post-intervention score was 97.05, indicating an increase of 1.84. There was a significant increase in the fourth dimension of open-mindedness (z = -2.80, p < 0.01). The learning experience has been likened to a process of clearing the fog, and it involves the use of limited known conditions, thinking outside the box, and adaptation to complex care issues. Using the OPT clinical reasoning model as a teaching strategy during a psychiatric nursing internship significantly improved the open-mindedness dimension among the students. The student reflective experience of talking to teachers as peers helped students identify clues and reframe problems related to clinical care. Additionally, the students reported that this led to more harmonious interactions with their teachers.

Cross-border food remittances and mobile transfers: The experiences of Zimbabwean migrants in Cape Town, South Africa

Mobile transfers have become a defining feature of cross-border remittance transmission in Sub-Saharan Africa (SSA). However, recent studies on mobile transfers have mainly focused on cash remittances and need to pay more attention to mobile food transfers. This paper addresses this research gap on mobile food transfers by examining cross-border food remittances and mobile transfers by Zimbabwean migrants residing in Cape Town, South Africa, to their families and friends back home. In this paper, we seek to understand the factors influencing the uptake of digital food remittances by Zimbabwean migrants who have lived in South Africa for at least three years. The paper is based on a mixed research study carried out in Cape Town during the nationwide COVID-19 lockdown in 2020. The mixed-methods study involved a questionnaire survey of 100 Zimbabwean nationals that was complemented by in-depth interviews with 10 participants selected from the interviewed group. The study findings reveal that the national COVID-19 pandemic lockdown disrupted informal food-remitting channels and, at the same time, helped to solidify the digital and mobile food transfers across national borders that have emerged in SSA in recent years.

Identifying Effective Managerial Factors in Improving and Renovating Old Urban Tissues: A Case Study Approach

This paper attempts to identify the effective managerial factors in renovating old building tissues in a city in Iran (Langrud). The present research is practical in terms of purpose, and it is descriptive and contextual in terms of data collection. Furthermore, since this is a mixed research study from both the perspective of its nature and purpose, we conducted the study with both qualitative (interviews) and quantitative (questionnaires) methods. As the statistical population in the qualitative section consists of experts on improving worn-out tissues, we used an available sampling method and took into account the individuals’ characteristics in the sampling process. Seven managers, assistants, and engineers with more work experience than the rest of the managers and assistants were selected. During the quantitative phase, the population included all the municipality staff and the engineering system organization of Langrod city, which contains a total of 650 people. A total of 335 people were selected, and the questionnaire was distributed using Cochran’s formula. A semi-structured interview and a questionnaire were used as research tools distributed among participants. The validity and reliability of the questionnaires were determined based on existing standards. Additionally, the data were analyzed using Factor Analysis (FA), the Fuzzy Analytic Hierarchy Process (FAHP), and Structural Equations Modeling. According to the results, the most effective managerial factors and indicators in the improvement and renovation of the city’s old tissues were related to resources. Next, attention to training, commitment to environmental assessment, idea creation, planning, management, technical factors, experience, attention to legal requirements, and attention to external factors are placed.