Modified Content Analysis Research Articles

Women’s support-seeking for reproductive decision-making in Australia: rationales and socio-demographic contexts

ABSTRACT While a positive relationship between social support and women’s reproductive decision-making outcomes exists, little is known about the reasons why women engage supporters to assist them when making reproductive decisions. This study explores Australian women’s reasons for engaging supporters for reproductive decision-making and whether women’s socio-demographic characteristics are suggestive of any such reasons. A modified content analysis approach, combining directed and summative analysis methods, was applied to data from two qualitative Australian studies exploring women’s support-seeking for reproductive decision-making. Findings suggest that the most important rationales for engaging supporters were ‘understanding or empathy’, ‘informed or educated’, ‘on the same page’, ‘little interference’, ‘close’ and ‘stake in the decision’. Some socio-demographic characteristics, particularly regional area and partner status, helped to explain some reasons, while other reasons were better explained by the nature of the decision being made. Further research is required to enhance our understanding of reproductive decision-making processes and enable women to access support that facilitates decisions appropriate to their bodies and life circumstances.

ОСОБЕННОСТИ РЕЧЕВОГО ПОВЕДЕНИЯ ВИДЕОБЛОГЕРОВ НА ПРИМЕРЕ ОБЗОРОВ ТРАНСПОРТНЫХ СРЕДСТВ

The aim of this article is to identify the features of speech behavior of video bloggers from the point of view of pragmalinguistics, where the main object of the research is the communicant’s conscious and unconscious choice of speech means. The method of traditional content analysis is used to study the conscious choice of language means by a video blogger, while the method of modified content analysis is used to study the unconscious choice. Fragments of speech of videoblogers, whose videos are devoted to retro vehicles reviews were taken as a research material. This article defines such concepts as Internet discourse, blog and video blog, and also identifies and shows on examples the common linguistic features that are found among video bloggers in the field of retro transport. These features will allow to further form speech portraits of video bloggers and determine their personal traits. These traits show what norms of culture, behavior, communication, even the psychology of people’s thinking are formed among representatives of different generations under the influence of the World Wide Web.

Эмотивность и ее проявление в речи русских и американских тревел-видеоблогеров

The relevance of the work is due to the interest of the scientific linguistic community in the problem of the manifestation of emotivity among representatives of different nationalities during the creation of travel video blogs. The main purpose of this work is to diagnose emotional characteristics and to make a comparative analysis of the speech manifestation of emotions in Russian and American travel video bloggers. This article presents an experiment that is carried out within the framework of the modified content analysis method in the aspect of hidden pragmalinguistics. During the experiment, some categories of emotions of travel video bloggers were discovered, which were identified based on the frequency of actualization in their texts of some plans of speech strategies of hidden influence. Positive and negative emotions were found among the emotions of Russian travel video bloggers, such as joy, enthusiasm, enthusiasm, indignation, resentment, anxiety. American travel video bloggers expressed positive and neutral emotions in their videos. The following emotions were revealed: satisfaction, inspiration, delight. At the same time, there was a manifestation of confidence. Based on the data obtained, a comparative analysis was conducted, during which it turned out that Russian video bloggers had a gender division in the process of analyzing emotive features, which manifested itself in the fact that men are prone to negative emotivity, whereas women are usually positive. American travel video bloggers did not show any negative manifestations of emotions.

Safety on the ground: using critical incident technique to explore the factors influencing medical registrars’ provision of safe care

BackgroundAvoidable patient harm in hospitals is common, and doctors in training can provide underused but crucial insights into the influencers of patient safety as those working ‘on the ground’ within...

Bloggers’ Speech Behavior: Analysis and Diagnosis of Personal Traits from the Perspective of Implicit and Functional Pragmalinguistics

The aim of this paper is to present a comprehensive methodology for conducting both traditional and modified content analysis using transcripts of spoken language from video bloggers as source material. The specific focus of this research centers around video content dedicated to reviewing retro automotive vehicles. The authors delve into two fundamental branches of pragmalinguistics, namely the implicit and functional aspects, while also detailing the analytical techniques employed within these paradigms. The practical application of these methods is illustrated using the oral speeches of the blogger Alexander Chikunov as a case study, providing a clear and tangible demonstration of the process for diagnosing individual personality traits. The initial phase involves an analysis of the material through the lens of implicit pragmalinguistics, encompassing the frequency analysis of speech patterns within the context of selected linguistic strategies, coupled with rigorous statistical data processing. The outcomes pertaining to a specific blogger are subsequently juxtaposed against data from other bloggers within the same genre, thereby facilitating the identification of shared, stereotypical, and unique personality characteristics attributed to the blogger. Moving forward, this article highlights individual traits of the blogger, which were discerned through traditional content analysis techniques. Finally, the study involves an insightful interpretation of the acquired data, culminating in the development of a nuanced portrait of Alexander Chikunov’s speech behavior. A notable aspect of this research lies in its pioneering effort to discern and systematize linguistic features exclusively found within the domain of video blogs. This is achieved by utilizing unscripted spoken language from bloggers as empirical evidence, adding a distinctive dimension to the study’s scientific novelty.

An innovative sequential mixed-methods approach to evaluating clinician acceptability during implementation of a standardized labor induction protocol

BackgroundImplementation outcomes, including acceptability, are of critical importance in both implementation research and practice. The gold standard measure of acceptability, Acceptability of Intervention Measure (AIM), skews positively with a limited range. In an ongoing hybrid effectiveness-implementation trial, we aimed to evaluate clinician acceptability of induction standardization. Here, we describe an innovative mixed-methods approach to maximize the interpretability of the AIM using a case study in maternal health.MethodsIn this explanatory sequential mixed methods study, we distributed the validated, 4-question AIM (total 4–20) to labor and delivery clinicians 6 months post-implementation at 2 sites (Site 1: 3/2021; Site 2: 6/2021). Respondents were grouped by total score into tertiles. The top (“High” Acceptability) and bottom (“Low” Acceptability) tertiles were invited to participate in a 30-minute semi-structured qualitative interview from 6/2021 to 10/2021 until thematic saturation was reached in each acceptability group. Participants were purposively sampled by role and site. Interviews were coded using an integrated approach, incorporating a priori attributes (Consolidated Framework for Implementation Research constructs) into a modified content analysis approach.Results104 clinicians completed the initial survey; 24 were interviewed (12 “High” and 12 “Low” Acceptability). Median total AIM scores were 20/20 IQR[20–20] in the High and 12.5/20 IQR[11–14] in the Low Acceptability groups. In both groups, clinicians were enthusiastic about efforts to standardize labor induction, believing it reduces inter-clinician variability and improves equitable, evidence-based care. In the Low Acceptability group, clinicians stated the need for flexibility and consideration for patient uniqueness. Rarely, clinicians felt labor induction could not or should not be standardized, citing discomfort with medicalization of labor, and concerns with “bulldozing” the patient with interventions. Suggested strategies for overcoming negative sentiment included comprehensive clinician education, as well as involving patients as active participants in the protocol prenatally.ConclusionsThis study utilized AIM in an innovative sequential mixed-methods approach to characterize clinician acceptability, which may be generalizable across implementation endeavors. By performing this work during a hybrid trial, implementation strategies to improve acceptability emerged (clinician education focusing on respect for flexibility; involving patients as active participants prenatally) for year 2, which will inform future multi-site work.

Determinants of Blood Culture Use in Critically Ill Children: A Multicenter Qualitative Study.

We conducted semistructured interviews of clinicians (M.D., D.O., R.N., N.P., P.A.) from 6 PICUs who had participated in a quality improvement collaborative about blood culture practices. We developed interview questions by combining elements of the Consolidated Framework for Implementation Research and behavioral economics. We conducted telephone interviews, open-coded the transcripts, and used modified content analysis to determine key themes and mapped themes to elements of Consolidated Framework for Implementation Research and behavioral economics. We reached thematic saturation in 24 interviews. Seven core themes emerged across 3 Consolidated Framework for Implementation Research domains: individual characteristics [personal belief in the importance of blood cultures, the perception that blood cultures are a low-risk test]; inner setting [adherence to site-specific usual practices, site-specific overall approach to PICU care (collaborative versus hierarchical), influence of non-PICU clinicians on blood culture decisions]; and outer setting [patient-specific risk factors, sepsis guidelines]. In addition, outcome bias, default bias, and loss aversion emerged as salient behavioral economics concepts. Determinants of blood culture use include individual clinician characteristics, inner setting, and outer setting, as well as default bias, outcome bias, and loss aversion. These determinants will now inform the development of candidate strategies to optimize culture practices.

Lexical and grammatical means of expression of dominant assessment in media speech of virtual language personality in blogs: gender aspect

The aim of the study is to present an analysis of the lexical and grammatical means of expression of dominant assessment in the speech behavior of the Russian-speaking and English-speaking virtual language personality in blogs, depending on belonging to a particular gender. The research material is a card index of more than 200 posts of beauty bloggers on the social network in 2021. There were used 15 accounts of the Russian-speaking and 15 accounts of the English-speaking addressers. All blogger’s virtual language personalities position themselves on the Internet as men, transgender people (mtf – male-to-female) and women. In total more than 3,800 small syntactic groups have been analyzed. The following research methods were used in the work: the lexico-semantic, lexico-grammatical, and stylistic analyses, method of objective pragmalinguistic analysis combining modified content analysis and the comparison method. When studying the differences in the media speeches among the English- and Russian-speaking virtual communicative personalities, several lexical differences in the speeches of the women, men and transgender people were identified. Thus, among the Russian-speaking bloggers the highest percentage of negative attitudes and in general the brightest emotional coloring of lexis and grammar constructions was observed in the men’s media speech despite the widespread stereotype about the greater emotional intensity of women’s media speech. The women in their media speech tend to prevail in the formation of positive assessment. For the transgender people in blogs, all three indicators of the formation of assessment using lexical and grammatical means occupy a middle position between the media speech of the women and the men, which indicates the presence of female and male traits in the media speech of the transgender people. For the English-speaking virtual communicative personalities in the media speeches of the women and the men, all three indicators are approximately equal, while for the transgender people the index of the formation of a negative attitude using lexical and grammatical means is twice exceeded, and the indicator of the formation of a positive attitude through vocabulary is twice reduced. In general, the media speech of the English-speaking transgender people in blogs is characterized by a more open and more emotionally colored lexical and grammatical constructions in media speech. The transgender bloggers share all the events from their lives, regardless of whether they are positive or negative, which indicates maximum self-presentation and maximum attention of Internet users to their language personality and lifestyle among Internet users. It seems promising to consider the linguopragmatic aspect of gender self-presentation of virtual language personalities in blogs, to identify the main tactics of their self-presentation in media space.

Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process.

Annual increases in the number of residency applications burden students and challenge programs. Several reforms to the application process have been proposed; however, stakeholder input is often overlooked. The authors examined key stakeholders' opinions about several proposed reforms to the residency application process and identified important factors to guide future reforms. Using semistructured interviews, the authors asked educational administrators and trainees to consider 5 commonly proposed reforms to the residency application process: Match to obtain residency interviews, preference signaling, application limits, geographic preference disclosure, and abolishing the Match. The authors conducted a modified content analysis of interview transcripts using qualitative and quantitative analytic techniques. Frequency analysis regarding the acceptability of the 5 proposed reforms and thematic analysis of important factors to guide reform were performed. Fifteen-minute interviews were conducted between July and October 2019, with data analysis completed during a 6-month period in 2020 and 2021. Participants included 30 stakeholders from 9 medical specialties and 15 institutions. Most participants wanted to keep the Match process intact; however, they noted several important flaws in the system that disadvantage students and warrant change. Participants did not broadly support any of the 5 proposed reforms. Two themes were identified: principles to guide reform (fairness, transparency, equity, reducing costs to students, reducing total applications, reducing work for program directors, and avoiding unintended consequences) and unpopular reform proposals (concern that application limits threaten less competitive students and signaling adds bias to the system). Key stakeholders in the residency application process believe the system has important flaws that demand reform. Despite this, the most commonly proposed reforms are unacceptable to these stakeholders because they threaten fairness to students and program workload. These findings call for a larger investigation of proposed reforms with a more nationally representative stakeholder cohort.

Shared decision making: A novel approach to personalized treatment in obstructive sleep apnea

Study objectivesi) To describe a novel approach of phenotyping by shared decision making (SDM) in obstructive sleep apnea (OSA) discharge consultations ii) to describe correlation between patient and observer based evaluations of SDM and iii) to describe treatment adherence. MethodsConsecutive patients referred to the otorhinolaryngology department at Akershus University Hospital with suspected OSA between 2015 and 2016 participated. Patients with body mass index >30 were oversampled. Four male communication-trained doctors aged from 30 to 60 years participated. SDM was evaluated by modified content analysis and by the CollaboRATE self-report questionnaire and the “Observer OPTION (Young et al., 2008) [5]” rating scale. Positive airway pressure (PAP) treatment adherence and weight reduction was assessed by interview at six year follow-up. ResultsEighteen consultations were video filmed. The content analysis revealed that the patient perspectives only briefly were explored. PAP was chosen by 17 of 18 patients. Median CollaboRATE questionnaire score was 29 (26, 30). Mean OPTION (Young et al., 2008) [5] score was 65.6 (SD 6.6, range 55–80). The correlation between SDM assessed by CollaboRATE self-report and by the “Observer OPTION (Young et al., 2008) [5]” rating scale was low (Pearson's r = 0.09). At follow up, 11 patients (64.7%) were PAP adherent and no one achieved 10% weight loss. ConclusionsDespite a high degree of SDM compared to studies of non-OSA populations, the sub-optimal exploration of the patient perspective by communication-trained doctors precluded identification of patients willing to cope actively. SDM assessed by self-report and by a rating scale may represent two different constructs. PAP adherence was good.

Home pulse oximetry after discharge from a quaternary-care children's hospital: Prescriber patterns and perspectives.

Pulse oximetry monitoring is prescribed to children receiving home oxygen for chronic medical conditions associated with hypoxemia. Although home pediatric pulse oximetry is supported by national organizations, there is a lack of guidelines outlining indications and prescribing parameters. A mixed-methods analysis of pediatric home pulse oximetry orders prescribed through the institutional home healthcare provider at a large US children's hospital 6/2018-7/2019 was retrospectively reviewed to determine prescribed alarm parameter limits and recommended interventions. Semi-structured qualitative interviews with pediatric providers managing patients receiving home oxygen and pulse oximetry were conducted to identify opportunities to improve home pulse oximetry prescribing practices. Interviews were analyzed using a modified content analysis approach to identify recurring themes. A total of 368 children received home pulse oximetry orders. Orders were most frequently prescribed on noncardiac medical floors (32%). Attending physicians were the most frequent ordering providers (52%). Frequency of use was prescribed in 96% of orders, however, just 70% were provided with specific instructions for interventions when alarms occurred. Provider role and clinical setting were significantly associated with the presence of a care plan. Provider interviews identified opportunities for improvement with the device, management of alarm parameter limits, and access to home monitor data. This study demonstrated significant variability in home pulse oximetry prescribing practices. Provider interviews highlighted the importance of the provider-patient relationship and areas for improvement. There is an opportunity to create standardized guidelines that optimize the use of home monitoring devices for patients, families, and pulmonary providers.

Creating a Common Language: How Solution Focused Brief Therapy Reflects Current Principles of Change and Common Factors 🇨🇳 🇹🇼 🇫🇷 🇮🇷

The common factors and mechanisms of change have been investigated across many disciplines and in many fields. This study applies the common factors to Solution Focused Brief Therapy (SFBT) through a modified content analysis of the BRIEFER Practice Manual. Seven common factors themes are identified and applied to SFBT. The study concludes with a consideration of how this common factors approach broadens the evidence-base of SFBT and provides suggestions for implementation and application of this common factors approach. Chinese (Simplified) (https://drive.google.com/file/d/1UemtSluW3mvD2GPVQ4j-HAMLnhQ2DHMr/view?usp=drive_link) Chinese (Traditional) (https://drive.google.com/file/d/1sBbxUT8SXxKDF3ps5Ykuzqq54oGJ8QS-/view?usp=drive_link) French (https://drive.google.com/file/d/1jOPWNFHrf44pPnvNCppY7UkxenC9fy_G/view?usp=drive_link) Persian (https://drive.google.com/file/d/1Qub9bjr4h64b9ZcDDfo3t_XM1kay-tju/view?usp=drive_link)

"To Conserve Fighting Strength": The Role of Military Culture in the Delivery of Care.

There are ongoing discussions about reorganizing the delivery of health care within the US Armed Forces. The military cultural context of care has beneficial qualities for patients with orthopedic and extremity trauma acquired during deployments to conflict zones. The study included 35 participants with lower limb amputations who had been discharged from the Amputee Patient Care Program ≥ 12 months prior to the study. Participants were interviewed using a lightly structured schedule designed to elicit accounts of community integration, which attended to reports of belongingness supported by accounts of social engagement in work, school, family, and social events. Interviews were analyzed using a modified content analysis approach. Participants generally described their postcare lives as "successful" that had been built on "good outcomes." For most former patients, remembering the social intensity of their rehabilitation program was an important element in their narratives of recovery. Weekly amputee clinics worked to alleviate stress and anxiety in participants' minds around the complexities of their injuries and care. Participants reported that features of their care were particularly valuable to their recovery and their current assessment of their injury related health. These features are present, in part because of the military cultural context that is part of the framework of care delivery.

Gender Discrimination Among Academic Physicians.

Background: There is a growing body of literature showing that gender discrimination impacts physicians' work and life experiences. Impact on income, promotion, and parenthood has been documented. Based on these findings, we hypothesized that the experiences of academic physicians who identify as women or gender nonconforming would be different from their counterparts who are men. This survey study explores the influences of gender on academic physicians' experiences with discrimination in life and at work.Materials and Methods: In the spring of 2017, academic physicians (n = 752) at a medical school in the West were invited to participate in a survey that measured experiences with discrimination using the Everyday Discrimination Scale and additional items. We used a mixed-methods approach to analyze the data, employing chi square and t-tests to analyze quantitative data and modified content analysis to code open-ended responses.Results: The response rate was 24% (180/752). There was no significant difference between women and men in reported frequency of discrimination in everyday life (p = 0.474). However, women were significantly more likely than men to select gender as a reason for being treated differently in everyday life (p = 0.000) and report discrimination in the workplace (p < 0.000). Open-ended responses describing experiences of discrimination differed based on gender: women were twice as likely than men to report receiving negative treatment owing to gender. Finally, men discussed having gender privilege, whereas women discussed experiencing gender discrimination.Conclusions: This study contributes to the growing body of literature about how gender influences the experience of practicing medicine.

The extent of inclusion of the skills of the twenty-first century in the Arabic language book for the sixth grade in Jordan The academic year 2018-2019 is a model: مدى تضمين مهارات القرن الحادي والعشرين في كتاب اللغة العربية للصف السادس الأساسي في الأردن العام الدراسي 2018-2019 أنموذجاً

The present study aimed to identify the extent to which the 21st century skills were included in the Arabic language book for the sixth grade in Jordan. To achieve this objective, the researcher used the descriptive analytical method using the modified content analysis form by the researcher. (7) areas: - Critical thinking and problem solving - Innovation and creativity - Collaboration and work in the team - Leadership - Understanding multicultural culture - Communication, information and information - Culture of computing and information technology and communication - Profession and self-reliant learning. Study in the book of the Arabic language for the sixth grade the first two chapters and the second academic year 2018/2019, and data analysis was used) Hambleton repetitions and percentages, averages, and the expense of honesty has been applied Hampelton equation. And Alpha Kronbach. The results of Test-Retest showed that the method of retest was applied In the light of the results, the researcher recommended reviewing the content of the Arabic language courses for the basic stage in terms of dealing with the skills of the 21st century, in view of their importance in preparing the learner Capable of coping with the challenges and addressing the problems that may be faced.

Social enterprise: Exploring an integrative definition

Introduction&lt;br/&gt; The world is witnessing the rise of social enterprises today. These organisations are formed by social entrepreneurs who are equipped with the resourcefulness of a traditional entrepreneur and have a social mission. They are focused on generating social value, thereby creating an impact on society. There is no universally accepted definition for a social enterprise, largely due to the contextual factors associated with it. The literature is also weighted to Western discourse and not much is available beyond the Western world. Today, social enterprises are emerging worldwide, and India is no exception. However, there is no formal, legally sanctioned organisational type which has an impact on how social enterprises are identified in India. By understanding what social enterprise looks like in India, we are able to add to the academic conversation on what a social enterprise is, by building our definitional understanding about it.&lt;br/&gt; Objective&lt;br/&gt; The changing world ecosystem is characterised by the coexistence of economic growth and changing technology along with income inequality and disparity in inclusion and equity. Emerging markets like India are characterised by these conditions. This also creates unmet opportunities for businesses which can focus on localised solutions, serve local communities, and do good for society as a whole. A social enterprise has strategic advantages over traditional organisations and has, therefore, a broader role to play in supporting inclusive growth in such markets. However, lack of basic understanding, recognition and subsequent policies supporting these organisations can, in turn, inhibit their progress. To that end, this paper attempts to create an integrative definition of a social enterprise, keeping India as a context, to advocate its recognition and also to promote knowledge building in the domain.&lt;br/&gt; Methods&lt;br/&gt; The identified research theme is at a nascent stage and hence has been based on the usage of a multi-method qualitative methodology which involves two qualitative 1 data collection procedures and modified content analysis.&lt;br/&gt; Results&lt;br/&gt; An integrative definition of a 'social enterprise' has been proposed on the basis of the emergent insights.

Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health in Response to the CHRONIC Care Act

The passage of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act in 2018 allows Medicare Advantage (MA) plans, which enroll more than one-third of Medicare beneficiaries, greater flexibility to address members' social determinants of health (SDOH) through supplemental benefits. To understand MA plan representatives' perspectives on the importance of addressing members' SDOH and their responses to the passage of the CHRONIC Care Act. This semistructured qualitative interview study conducted via telephone from July 6, 2018, to November 7, 2018, included participants from 17 MA plans that collectively enrolled more than 13 million MA members (>65% of the total MA market). Data analysis was conducted from September 18, 2018, to December 13, 2018. Audio-recorded interviews were transcribed and then analyzed using a modified content analysis approach to identify major themes and subthemes. Thirty-eight participants representing 17 MA plans varying in region, star rating, and size were interviewed. Analysis of interviews revealed 3 key themes. The first theme was that participants increasingly recognize the value of addressing members' SDOH. The second theme was that participants had different perspectives on whether MA plans should directly address SDOH and how to do so. While some reported that they were taking advantage of the increased flexibility provided by the CHRONIC Care Act to design new benefits or partner with community-based organizations, others indicated that it was outside of their purview to directly address members' SDOH. The third theme was that participants described complex decision-making around how to provide supplemental benefits, including a need for evidence, return on investment, strong community partnerships, and guidance from the US Centers for Medicare & Medicaid Services. These findings suggest that the changes in MA plans' benefit packages in response to the CHRONIC Care Act and their efforts to address SDOH will vary. Therefore, it is likely that MA enrollees will be differentially affected by the implementation of the CHRONIC Care Act.

Pedagogy and public-funded research: an exploratory study of skills in digital humanities projects

PurposePublic-funded research in digital humanities (DH) enhances institutional and individual research missions and contributes open data to a growing base of globally networked knowledge. The Digging into Data 3 challenge (DID3) (2014–2016) is an international, interdisciplinary and collaborative grant initiative, and the purpose of this paper is to explore skills that faculty and students brought to projects and others they acquired and shared on collaborative teams.Design/methodology/approachRooted in the naturalistic paradigm, this qualitative case study centers on semi-structured interviews with 53 participants on 11 of the 14 DID3 projects. Documentary evidence complements empirical evidence; analysis is constructivist and grounded.FindingsHailing from diverse academic research institutions, centers and repositories, participants brought 20 types of discipline-based or interdisciplinary expertise to DID3 projects. But they reported acquiring or refining 27 other skills during their project work. While most are data-related, complementary programming, management and analytical skills push disciplinary expertise toward new frontiers. Project-based learning and pedagogy function symbiotically; participants therefore advocate for aligning problem-solving skills with pedagogical objectives at home institutions to prepare for public-funded DH projects. A modified content analysis juxtaposes DID3 skills with those advanced in 23 recent DH syllabi to identify commonalities and gaps.Originality/valuePedagogy has an important yet under-researched and underdeveloped role in public-funded DH research.

Principals’ instructional leadership under statewide teacher evaluation reform

Purpose The purpose of this paper is to describe how elementary school principals adjust their leadership practice in response to Washington’s new teacher evaluation policy. Design/methodology/approach The authors conducted a modified content analysis of open-ended survey responses collected from elementary school principals in Washington State. In all, the survey included responses from 354 elementary school principals representing 25.0 percent of the state’s elementary school principal population. ATLAS.ti supported data analysis and assisted in the derivation of three key findings. Findings Elementary school principals changed their instructional leadership practice in response to the new teacher evaluation policy in three significant ways. First, principals adjusted their approach to classroom observation to complete more intentional, in-depth observational activities. Second, principals redistributed non-instructional responsibilities to clerical staff members to allow themselves and other administrators more time for classroom observation. Third, principals adopted a learning stance to the new policy and thus sought external support, especially coaching, to assist them with the implementation of new evaluation practices. Research limitations/implications The study faced three limitations. First, the sample of respondents included in this study cannot be generalized to the state as participants were not randomly selected. Second, the survey did not utilize a longitudinal design, and thus its findings only relate to the first year of the policy’s implementation. Third, the study does not include school-based evidence to triangulate principals’ survey responses. Originality/value The study contributes to the instructional leadership literature. Specifically, the study offers further insights into the adjustments principals make in their leadership to accommodate expectations found in new teacher evaluation policy.

Why Do People With Schizophrenia Exercise? A Mixed Methods Analysis Among Community Dwelling Regular Exercisers.

Individuals with schizophrenia have reduced rates of physical activity, yet substantial proportions do engage in independent and regular exercise. Previous studies have shown improvement in symptoms and cognitive function in response to supervised exercise programs in people with schizophrenia. There is little data on motivations of individuals who exercise independently, or their chosen type, duration, or setting of exercise. This study explores motivational parameters and subjective experiences associated with sustained, independent exercise in outpatients with a diagnosis of schizophrenia or schizoaffective disorder. Participants completed a semi-structured interview and then were given a prospective survey containing visual analog scales of symptom severity and the Subjective Exercise Experiences Scales to complete immediately before and after three sessions of exercise. Results from the semi-structured interview were analyzed by modified content analysis. The most important reason for exercise was self-image, followed closely by psychological and physical health. Among psychological effects, participants reported exercise was most helpful for mood and cognitive symptoms. The prospective ratings demonstrated 10–15% average improvements in global well-being, energy, and negative, cognitive and mood symptoms, with almost no change in psychosis, after individual exercise sessions. This suggests that non-psychotic parameters are more susceptible to inter-session decay of exercise effects, which may reinforce continued exercise participation.