Explanatory Sequential Mixed Methods Research Articles

Exploring technical and vocational education and training and its relationship to employment in Nepal: a mixed methods study

This study was conducted to explore the relationship between actors of education and employment systems in Nepali Technical and Vocational Education and Training (TVET) system. The study measured the engagement of actors from both systems in the curriculum process: design, application, and feedback phases. Further, it explained why the actors of these systems have weak relationships in Nepal. This study used an explanatory sequential mixed methods approach. First, we collected the information with 124 TVET experts with at least five years of experience to calculate the linkage index score. Second, we interviewed 15 individuals who were the respondents in the first survey. The survey revealed that although the education and employment system has gradually increased collaboration in the last few years, particularly since 2018, education actors still have more power for decision-making across all three curriculum phases. The study revealed that employers’ lack of meaningful participation in the curriculum design phase impedes them from engaging in the curriculum application and excludes them in the feedback phase. This study contributes an essential insight to bridging a gap between actors of the education and employment system.

Internet-Based Dementia Prevention Intervention (DementiaRisk): Protocol for a Randomized Controlled Trial and Knowledge Translation.

Research has shown that engaging in a range of healthy lifestyles or behavioral factors can help reduce the risk of developing dementia. Improved knowledge of modifiable risk factors for dementia may help engage people to reduce their risk, with beneficial impacts on individual and public health. Moreover, many guidelines emphasize the importance of providing education and web-based resources for dementia prevention. Internet-based interventions may be effective, but few have been studied rigorously or widely disseminated. We created DementiaRisk, an award-winning, web- and email-based education platform for the public focused on modifiable risk factors, featuring multimedia e-learning and email "microlearning" content, to help raise awareness and improve knowledge of actions to reduce dementia risk. This protocol describes a randomized controlled trial to (1) evaluate whether exposure to DementiaRisk changes knowledge of dementia risk factors, intention to engage in risk reduction activities, and health behaviors related to dementia risk reduction and to (2) explore qualitative aspects including participants' engagement and satisfaction with the intervention and barriers and facilitators to use. Using a sequential explanatory mixed methods design, this study conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. In total, 485 participants will be recruited on the web and randomly assigned to 2 groups: one accessing DementiaRisk and the other receiving alternative e-learning on mild cognitive impairment. Assessments will be delivered on the web at baseline (T1), at 4 weeks (T2), and at 2 months after the intervention (T3). Knowledge will be assessed using items from the Dementia Knowledge Assessment Scale, intentions to engage in risk reduction activities will be assessed using items in line with current evidence, and health behaviors related to dementia risk reduction will be assessed using items from the Godin-Shephard Leisure Time Physical Activity Questionnaire along with additional questions related to a range of health status domains. Outcomes and feasibility will be assessed using the Information Assessment Method for patients and consumers. A linear mixed effects model will be used to examine the relationship between each outcome score by group and time point. This study was approved by the Hamilton Integrated Research Ethics Board on August 24, 2022 (project ID 14886) and received funding in February 2023. Recruitment took place from March 28, 2023, to April 28, 2023, with the final participants completing the intervention by August 18, 2023. Analyses and interpretation of data are ongoing. DementiaRisk is a readily scalable, technology-enhanced solution for dementia prevention education. It has been designed using evidence-based principles of multimedia learning. It has the potential to scale and spread widely using the open internet, so it may be able to reach a wider audience than traditional in-person educational interventions. ClinicalTrials.gov NCT05383118; https://clinicaltrials.gov/study/NCT05383118. DERR1-10.2196/64718.

Sustainable Human Resource Training: A study of Scale Development and Validation

In the contemporary world, organizations are expected to introduce human resource management (HRM) practices which foster organizational sustainable development. The latter is based on the integration of environmental, social, and economic goals. Moreover, HRM practices should contribute to the common good. HR training has been found as a means to transfer sustainability theory into practice. However, to be called sustainable, HR training should not only promote employees’ sustainability-oriented behaviours but also be internally sustainable and contribute to common good. Such an approach has not been represented in previous research. Therefore, this study aims to develop a sustainable HR training construct. An exploratory sequential mixed method approach was adopted to develop and validate the measurement scale of sustainable HR training. Data were collected from employees working in different industries of Poland. This study established the second-order construct of sustainable HR training, which comprises equal training opportunities, long-term oriented training, integrated approach to training, focus on well-being, environmental-oriented training, and team building as its first-order dimensions. It also confirmed the nomological validity of the newly developed scale based on its relationship with a company’s sustainable performance. The current research enriched the sustainable HRM literature by offering a high-order sustainable HR training construct. Practitioners and policy makers may employ the designed scale in spurring HR training practices along with enhancing their sustainable performance.

The human touch: investigating the importance of anthropomorphism in retaining episodic volunteers

PurposeThe objective of this study is to investigate how anthropomorphic perceptions of a film festival influence volunteers’ intention to continue volunteering. Specifically, it aims to understand the mediating roles of psychological proximity, psychological contract and commitment in shaping this relationship, with a focus on volunteers at film festivals in Indonesia.Design/methodology/approachThe study employs a sequential explanatory mixed method by conducting an online survey towards volunteers and in-depth interview to selected informants. Data from 80 volunteers was analysed using partial least square structural equation modelling (PLS-SEM) to test the hypotheses. Further, in-depth interviews with 15 volunteers were also conducted and the data was analysed using content analysis to obtain deeper understanding of the phenomena.FindingsThis study found that identification provides a positive influence to volunteers’ intention to continue volunteering in a film festival. Identification is influenced by psychological proximity, which also proven to provide positive influence on psychological contract and commitment (identification and contribution). Further, this study also provides empirical evidence that psychological proximity is influenced by aspects of anthropomorphism namely moral virtue and conscious emotions.Originality/valueThis study is the first study to empirically test the anthropomorphism concept to uncover the continuance intention of film festival volunteers. Two mechanisms of anthropomorphism influence intention to continue volunteering: the indirect relationship from moral virtue to intention to continue volunteering and from conscious emotions to intention to continue volunteering.

Patient Experiences and Perspectives When MyChart is Introduced in a Large Community Hospital: Mixed Methods Study.

Patient portals, or secure websites linked to electronic medical records, have emerged as tools to provide patients with timely access to their health information. To support the potential benefits of patient portals such as improved engagement in health care, it is essential to understand how patients and caregivers experience these portals. This study aimed to explore patient and caregiver experiences, facilitators, and barriers to accessing and using a patient portal called MyChart during the initial stages of its implementation. We applied explanatory sequential mixed methods to conduct a web-based questionnaire and semistructured interviews with MyChart users and nonusers at a large community hospital in Ontario, Canada. Among users, we explored user satisfaction with MyChart, its impact on care, and areas for improvement. For nonusers, we explored barriers to MyChart access and willingness to use it in the future. Descriptive statistics and thematic analysis were used for data analysis. A total of 5651 patients and caregivers completed the web-based questionnaire and 18 (12 users and 6 nonusers) participated in interviews. MyChart users primarily learned about the portal through email (n=1288, 39%), after-visit summaries (n=953, 29%), and hospital staff (n=408, 12%). Nonusers cited lack of awareness (n=1291, 59%) and registration difficulties (n=707, 32%) as some barriers to activation and adoption, but the majority would consider activating and using MyChart if they could learn more about it (n=1126, 54%). Users valued MyChart for preparing for health care encounters but expressed dissatisfaction with limited features and access to medical history and test results, whereas nonusers tended to be unsure about the benefits of using MyChart, especially if they were infrequent health care users. Patient portals offer benefits, but barriers to access and limited functionality can hinder widespread use. To enhance the adoption and potential benefits of patient portals, targeted outreach and comprehensive access to health information are essential to promote positive and seamlessly integrated health care experiences.

Evaluation of Virtual Reality Cultural Heritage Experience at Guilin Museum, China: A Conceptual Paper

Integrating Virtual Reality (VR) technology into cultural heritage presents unprecedented opportunities for enhancing museum experiences, specifically through immersive and interactive digital presentations (Theodoropoulos & Antoniou, 2022). Although virtual reality technology has the potential to enhance the experience of cultural heritage, according to previous research, it is not difficult to find that existing museum VR applications often lack an immersive experience, and many experiencers' immersion is interrupted during the experience, highlighting the urgent need for a VR application evaluation framework. In addition, most of the research is from the technology perspective, ignoring the users' experience needs. Therefore, the purpose of this conceptual paper is to present a conceptual framework that theoretically justifies the creation of a virtual reality evaluation. This conceptual paper begins by reviewing relevant research on VR in the cultural heritage field and methods and scales for measuring immersion. It suggests the possibility of utilizing grounded theory to uncover potential factors. Subsequently, this conceptual paper summarizes previous research and theoretical gaps. A conceptual framework for establishing a robust evaluation of virtual reality applications is proposed as a two-stage mixed research method (Exploratory Sequential Mixed Method Design) (Berman, 2017). This concept paper illustrates the details and rationalization of the conceptual framework so that it can be further investigated theoretically or empirically in the future. This concept paper contributes to developing an evaluation of VR cultural heritage applications. At the same time, it theoretically enhances the understanding of digital presentation and preservation of cultural heritage.

A Mixed Method Evaluation of Practitioners' Perspectives on Implementation Strategies for Healthy Eating and Active Living Policy, Systems, and Environmental Changes.

The National Cooperative Extension System is a leader in delivering healthy eating and active living (HEAL) policy, systems, and environmental (PSE) changes; however, these interventions are challenging, and technical assistance efforts often misalign with implementation science concepts. The study objective was to understand the importance of implementation strategies and tailoring needs to support Louisiana Nutrition and Community Health (NCH) practitioners' delivery of rural HEAL PSE changes. An explanatory sequential mixed method study design was used, including a survey to rank the importance of implementation strategies for HEAL PSE changes and a follow-up interview. A review of available implementation strategies (practice activities/resources) for Louisiana HEAL PSE changes was also conducted. This study occurred within Louisiana and focused on NCH practitioners' ongoing HEAL PSE change efforts throughout the state, with emphasis on rural community settings. All NCH practitioners were eligible to participate. "Practitioners" included Extension NCH administrators and agents/educators directly delivering HEAL PSE changes. The main quantitative outcome was the ranked importance of implementation strategies to support NCH practitioners' delivery of HEAL PSE changes. For explanatory interviews, perceptions of higher and lower ranked implementation strategies and tailoring opportunities were of interest. The alignment of available activities/resources with possible implementation strategies was also assessed. Highly ranked implementation strategies focused on engaging dedicated community partners and community members and starting small to ensure success, generate buy-in, and demonstrate feasibility. Opportunities for capacity building in these areas were identified. A lower ranked implementation strategy, changing organizational structures, was considered less likely to occur but possibly necessary to improve job satisfaction, retention, and return on investment. Available activities/resources overlapped with a few available implementation strategies. This study identified opportunities to use implementation science concepts to improve program support for NCH practitioners delivering complex HEAL PSE changes.

Examining Teachers’ Ratings and Perspectives on Literacy Acquisition in the Early Childhood Classroom

Literacy continues to plague education systems, particularly in the Caribbean; none withstanding teachers’ perceptions can inform strategies to improve students’ literacy achievement. The study examined teachers’ perspectives on literacy acquisition to understand the literacy instruction provided in the early childhood classroom. Data was collected from Grade I and II teachers through semi-structured interviews and a questionnaire using an explanatory sequential mixed methods research design. Teachers rated their students’ reading readiness and emergent literacy as high, indicating that their students acquire literacy through teacher-centered and child-centered approaches in literacy instruction. Significant disparities occurred between districts and literacy professional development levels. The main challenges cited for literacy acquisition were poor school attendance, poor attitude towards reading, lack of parental involvement, slow adaptation to change, and the unavailability of resources. Teachers shared a perspective of using a balanced approach, which represents a combination of skills-based and emergent literacy approaches to deliver literacy instruction. Quality literacy instruction, a mixture of constructivist and teacher centered approaches marred with parental involvement developed through focused literacy parenting sessions and a literacy-rich environment, can support the development of literacy acquisition.

Building safely, living well: combating substance abuse in the construction industry

In response to the persistent challenge of substance misuse within the construction industry, this study seeks to contribute valuable insights by identifying and evaluating effective mitigation strategies. This was done with the aim of informing evidence-based practices and promoting a safer and healthier work environment for construction industry stakeholders. This study employed a sequential exploratory mixed-method approach, combining both qualitative (Delphi technique) and quantitative (questionnaire) research methodologies. Data were obtained from professionals and non-professionals within Oyo State, Nigeria. Kruskal-Wallis test compared variables, while factor analysis identified patterns and relationships among potential mitigation strategies. Among the 18 mitigating strategies under examination, implementing random on-site drug testing policies was found to be statistically significant, indicating a strong connection to mitigating substance abuse within the construction industry. Additionally, the mitigating strategies were categorized into three clusters: policy enhancement and enforcement measures, research and training initiatives and treatment accessibility and support. This study is significant because it offers a solid foundation for understanding and addressing the pervasive issue of substance misuse within the construction industry. It not only advances knowledge in the field but also serves as a timely and crucial intervention in an area that has been relatively overlooked.

Preparing physiotherapists for the future: the development and evaluation of an innovative curriculum

BackgroundEducational innovation in health professional education is needed to keep up with rapidly changing healthcare systems and societal needs. This study evaluates the implementation of PACE, an innovative curriculum designed by the physiotherapy department of the HAN University of Applied Sciences in The Netherlands. The PACE concept features an integrated approach to learning and assessment based on pre-set learning outcomes, personalized learning goals, flexible learning routes, and programmatic assessment. PACE distinguishes itself from traditional education because of the flexible learning routes, vertical organization in learning communities, absence of pre-defined learning activities and class schedules, and a culture of continuous learning and development. PACE is based on three guiding principles: 1) flexible and varied, 2) self-directed and collaborative, 3) future-oriented. PACE was implemented in 2021 for first-year students. This study evaluates the implementation to inform future curriculum development.MethodsA sequential explanatory mixed methods design was used to evaluate the implementation of PACE using a questionnaire, focus groups, in-depth interviews, and a national progress test allowing for benchmarking results. Participants were undergraduate physiotherapy students of cohort 2021–2022, the first group who experienced PACE and teachers involved with this cohort. Questionnaire data were analyzed using descriptive statistics. To compare mean total scores of the national progress test between four different universities a one-way ANOVA was conducted including a post-hoc analysis. Reflexive thematic analysis guidelines were applied to analyze the interview data.ResultsIn total 82 first year students (44,6%) of cohort 2021–2022 and 36 teachers (60%) completed the questionnaire. Results show that the guiding principles were implemented as intended. Results of the national progress test on knowledge and clinical reasoning showed that students of the HAN University performed well compared to other universities. Thematic analysis of interviews and focus groups resulted in three themes and nine subthemes: 1) navigating a personalized curriculum, 2) caring and sharing, and 3) shaping professional identity. PACE contributed positively to students' intrinsic motivation, learning joy, identity development, and life-long learning skills. Areas for improvement were self-directed learning support, and teaching strategies to prompt deep learning.ConclusionThe evaluation showed that the guiding principles of PACE were implemented as intended and that the innovation positively contributed to student learning,

Enhancing Indonesian Language Learning Through TBLT and Google Classroom in Higher Education: Students’ Perceptions

Many studies have investigated Task-Based Language Teaching(TBLT) in language learning, but studies on the implementation of TBLT assisted by Digital Media in the current era have been rarely conducted by scholars. This study is intended to investigate students' perception of the implementation of TBLT assisted by Google Classroom, focusing on their learning experiences, the challenges they face, and the benefits and effectiveness of TBLT. This explanatory sequential mixed method involved 60 students of the Civil Engineering and Mechanical Engineering Study Programs at Eka Sakti University, Padang. The data of this study were gathered using a questionnaire and semi-structured interview. The quantitative data were analyzed quantitatively using descriptive statistics, while qualitative data were analyzed qualitatively using an interactive model. The results show that students’ perception of learning experiences, benefits, and effectiveness aspects were positive, while some students faced some challenges (e.g., task instruction, time allocation to do the tasks, internet connection, and work independently) in the challenge aspect in Indonesian language learning using TBLT assisted by Google Classroom. Although they faced some challenges, they overcame them by collaborating with their classmates in conducting institutions from the lecturer. Thus, it can be concluded that TBLT assisted by Google Classroom is effective in enhancing students’ Indonesian language skills and components, participation, learning interest, collaboration, and engagement. Thus, the TBLT approach integrated with Google Classroom is suggested to be employed by language instructors in teaching the Indonesian language course in Higher Education for non-Indonesian major students.

Factors affecting utilization of male sexual and reproductive health services: a qualitative description of males in Anambra State, Southeast Nigeria

IntroductionThe utilization of sexual and reproductive health (SRH) services by males globally is significantly low despite their considerable sexual and reproductive health needs. This study aimed to understand the factors that influence the utilization of male sexual and reproductive health SRH services.MethodsWe used an explanatory sequential mixed methods research design, with qualitative description to explore the perceptions of males (15-49years) on the utilization of male SRH services in Anambra State, Nigeria. In October 2021, 56 males participated in seven focus group discussions conducted across seven communities. The data were analysed by thematic analysis. A composite narrative was used to report the results.ResultsMales in both urban and rural areas of Anambra State preferred informal health facilities; male-focused health facilities and male health workers. The participants perceived services as costly; and criticized healthcare workers’ attitudes. Some rural areas had inadequate SRH facilities, staff and commodities. The participants exhibited varying levels of SRH awareness.ConclusionTo improve male SRH service utilization, clinics should be more male-centric and cost-effective. Healthcare providers require retraining to offer patient-centered care. Additionally, ward development committees should advocate for better staffing and the availability of SRH commodities.

Correlation between EFL Students Academic Achievement and Epistemic Beliefs in Relation to Educational Psychology Course

Educational psychology course and the epistemic beliefs of prospective teachers play a role in forming a competent teacher. While there is substantial literature exploring teachers’ epistemic belief, its interplay with course studies by prospective English teacher remains unclear. This research provides a novel understanding on the interplay of epistemic beliefs with educational psychology course, and achievement of prospective English teacher by integrating an explanatory sequential mixed methods design. Using quantitative survey to collect GPA (Grade Average Points), epistemic beliefs and perception of educational psychology, this study involve 102 EFL students at Brawijaya University through convenience sampling. Descriptive statistical and correlation analysis conducted in the first stage reveal their epistemic was moderate and their perception was high, and only between their epistemic beliefs and perception was found a strong correlation. Through confirming or disconfirming sampling, representative from the first stage participated in qualitative phase for semi-structured interview, resulting in justification of their positive perception and confirmation of the interconnection with epistemic beliefs. Findings imply there is a need to comprise aspects of high epistemic beliefs to have a more positive educational psychology course, that encourage adequate developmental feedback, active learning environments, inclusive advocacy, and student self-efficacy.. The high interest in unlisted content in the current module implies the need for material relevance of the course. The implication is for EFL teacher education to reconsider the content in educational psychology with students’ epistemic beliefs in order to equip English education students to become effective teachers.

Exploring Educators' Perceptions and Experiences of Online Teaching to Foster Caring Profession Students' Development of Virtual Caring Skills: Sequential Explanatory Mixed Methods Study.

Professionals in caring disciplines have been pivotal in advancing virtual care, which leverages remote technologies to deliver effective support and services from a distance. Educators in these caring professions are required to teach students the skills and competencies needed to provide high-quality and effective care. As virtual care becomes more integral, educators must equip students in these fields with both interpersonal and technological skills, bridging traditional hands-on learning with digital literacy. However, there is a gap in evidence exploring educators' perceptions and experiences of teaching caring profession students about virtual caring skills within online environments. This study aims to better understand caring profession educators' online teaching experiences to foster student development of virtual caring skills and competencies. We used a sequential explanatory mixed methods approach that integrated a cross-sectional survey and individual interviews with educators from caring professions to better understand caring professional educators' online teaching experiences to foster student development of virtual caring skills and competencies. The survey's primary objectives were to examine the various elements of existing e-learning opportunities, delve into educators' perspectives and encounters with these opportunities, and identify the factors that either facilitated or hindered online teaching practices to support students in developing virtual caring skills and competencies. The individual interview guides were based on survey findings and a systematic review of the evidence to gain deeper insights into educators' experiences and perspectives. A total of 82 survey participants and 8 interview participants were drawn from educators in the fields of education, medicine, nursing, and social work. Various instructional methods were used to help students develop virtual caring skills, including reflections on learning, online modules, online discussion boards, demonstrations of remote care, and consultation with clients. There was a statistically significant difference between educators' level of experience teaching online and their satisfaction with online teaching and learning technologies (P<.001) and between educators' faculties (departments) and their satisfaction with online teaching and learning technologies (P=.001). Participants identified barriers (time constraints, underdeveloped curriculum, decreased student engagement, and limited access to virtual caring equipment and technology), facilitators (clearly defined learning objectives, technology software and support, teaching support, stakeholder engagement, and flexibility), and principles of teaching virtual caring skills in online environments (connection, interaction, compassion, empathy, care, and vulnerability). Our study identifies the barriers, facilitators, and principles in teaching virtual caring skills, offering practical strategies for educators in caring professions. This study contributes to the growing body of educational research on virtual caring skills by offering educator insights and suggestions for improved teaching and learning strategies in caring professions' programs. As educational practices evolve, future research should explore how traditionally in-person educators can effectively teach virtual caring skills across diverse contexts.

Determinants of continuation on HIV pre-exposure propylaxis among female sex workers at a referral hospital in Uganda: a mixed methods study using COM-B model

BackgroundFemale sex workers (FSWs) have the highest HIV prevalence in Uganda. Pre-exposure prophylaxis (PrEP) has been recommended as a key component of the HIV combination prevention strategy. Although patient initiation of PrEP has improved, continuation rates remain low. This study evaluated PrEP continuation among FSWs and explored potential determinants of PrEP adherence within a public referral hospital in urban Uganda.MethodsWe conducted an explanatory sequential mixed method study at Kiruddu National referral hospital in Uganda. Secondary data on socio demographic characteristics and follow up outcomes of at least one year was collected for all FSWs who were initiated PrEP between May 2020 and April 2021 and data analyzed on July 15,2023. We used Kaplan–Meier survival analysis to evaluate continuation on PrEP from time of initiation and follow-up period. The capability, opportunity, and motivation to change behaviour model was used to explore perspectives and practices of FSWs (n = 24) and health care providers (n = 8) on continuation on PrEP among FSWs, using semi structured interviews. The qualitative data was deductively coded and analyzed thematically, categorizing the themes related to PrEP continuation as facilitators and barriers.ResultsOf the 292 FSWs initiated on PrEP, median age was 26 years (interquartile range, 21–29), 101 (34.6) % were active on PrEP, 137 (46.9%) were lost to follow-up, 45 (15.4%) were no longer eligible to continue PrEP, eight (2.7%) were transferred out and one (0.3%) had died. Median survival time on PrEP was 15 months (Interquartile range IQR, 3–21). The continuation rates on PrEP at six (6) and 12 months were 61.1% and 53.1%, respectively. Facilitators of PrEP continuation included awareness of risk associated with sex work, integration of PrEP with other HIV prevention services, presence of PrEP Peer support and use of Drop-in centers. The barriers included low community awareness about PrEP, high mobility of sex workers, substance abuse, and the unfavorable daytime clinic schedules. However, the quantitative findings from the multivariable Cox Proportional Hazards Model did not align with the reported findings for the qualitative evaluation.ConclusionContinuation on PrEP remains low among FSWs. Interventions for PrEP continuation should address barriers such as low community awareness of PrEP, substance abuse and restrictive health facility policies for scale of the PrEP program among FSWs in Uganda. Integration of PrEP with other services and scale up of community PrEP delivery structures may improve its continuation.

Determinants Affecting Air Cargo Operational Performance in Thailand: A Strategic and Mixed-Methods Approach

Background and Aims: The operational effectiveness of air cargo is a critical factor in global supply chains, as it impacts both economic growth and commerce efficiency. This study aims 1. To evaluate the impact of human, technological, cargo handling, and environmental factors on the operational efficiency of air cargo in Thailand, 2. To explore the practical insights associated with air cargo performance efficiency, and 3. To propose strategies for enhancing air cargo operational performance. Methodology: The authors employed a sequential explanatory mixed methods approach to investigate the determinants affecting air cargo operational performance. We investigated the impact of human, technological, cargo handling, and environmental factors on the operational performance of air cargo. Quantitative data were initially gathered via a survey of 431 participants, comprising cargo operation agents, customs officers, airport managers, and cargo handling and airline personnel in Thailand. Thirteen key informants were purposefully chosen to ensure their roles and experiences were highly relevant to the air cargo industry. Criteria included five years of professional experience, and involvement in critical areas such as cargo handling, capacity management, storage, operational coordination, or regulatory compliance. Results: It revealed significant relationships across all variables, with technological advancements exhibiting the strongest influence, followed by human factors, cargo handling processes, and environmental factors. In the subsequent qualitative phase, thematic analysis highlighted the critical role of technology including sorting technologies for loading/unloading, real-time tracking, predictive analytics such as demand forecasting, route optimization, and dynamic pricing integrating with human factors such as training, motivation, and teamwork to improve operational performance. Conclusion: The operational efficiency of air cargo is greatly affected by the adoption of advanced technologies, the improvement of human resource management, and the optimization of cargo handling processes, while considering environmental and external factors.

‘Citizenship from below’: integration as assemblage for immigrant young people volunteers in Canada

ABSTRACT One prominent issue facing Canada as an immigrant society pertains to the social and cultural integration of immigrant young people, who are often criticised in academic and popular discourse as passive citizens. Adopting an explanatory sequential mixed method approach, this study examines the civic engagement and participation of immigrant young people, via volunteering, as a ‘citizenship from below’. The concept of assemblage as a theoretical framework allows for an understanding of social integration as practices of ‘citizenship from below’ and social formations that are affective, relational and configured. One layer of social integration views immigrant young people volunteering as an assemblage that provides them with agency evolving over time as they mature and move more towards a deeper connection to community to effect change as a form of lived citizenship. Second, developing a sense of belonging and identity with Canada illustrates an affective dimension or layer in the assemblage of social integration. The study also suggests that young people volunteering-as-assemblage is an integral part of social integration and citizenship that is endlessly being socially produced and assembled. The findings challenge the diffuse negative perceptions about immigrant young people as passive citizens and extant knowledge about the relationships among immigration, integration, citizenship and belonging.

Identifying barriers and potential solutions to improve equitable access to community eye services: an exploratory sequential mixed methods study protocol

IntroductionAccess to care varies by sociodemographic group, with some groups facing higher barriers to care than others. This study will use novel methods to explore barriers and potential solutions as...

The Role of Sampling in An Explanatory Sequential Mixed Methods Study: General Applications of the Transformative Paradigm

The Role of Sampling in An Explanatory Sequential Mixed Methods Study: General Applications of the Transformative Paradigm

Advance care planning readiness, barriers, and facilitators among seriously ill Black older adults and their surrogates: A mixed methods study.

Advance care planning (ACP) supports communication and medical decision-making and is best conceptualized as part of the care planning continuum. Black older adults have lower ACP engagement and poorer quality of care in serious illness. Surrogates are essential to effective ACP but are rarely integrated in care planning. Our objective was to describe readiness, barriers, and facilitators of ACP among seriously ill Black older adults and their surrogates. We used an explanatory sequential mixed methods study design. The setting was 2 ambulatory specialty clinics of an academic medical center and 1 community church in Northern California, USA. Participants included older adults and surrogates. Older adults were aged 60+, self-identified as Black, and had received care at 1 of the 2 clinics or were a member of the church congregation. Surrogates were aged 18+ and could potentially make medical decisions for the older adult. The validated ACP engagement survey was used to assess confidence and readiness for ACP. What "matters most" and barriers and facilitators to ACP employed questions from established ACP materials and trials. Semi-structured interviews were conducted after surveys to further explain survey results. Older adults (N=30) and surrogates (N=12) were confident that they could engage in ACP (4.1 and 4.7 out of 5), but many were not ready for these conversations (3.1 and 3.9 out of 5). A framework with 4 themes - illness experience, social connections, interaction with health providers, burden - supports identification of barriers and facilitators to ACP engagement. We identified barriers and facilitators and present a framework to support ACP engagement. Future research can assess the impact of this framework on communication and decision-making.