Socio-contextual Factors Research Articles

Identity Work: A Qualitative Study of Residents' Experiences Navigating Identity Struggles.

Medical training traditionally holds a deterministic view of professional socialization wherein many medical learners struggle to construct a professional identity. Previous research has demonstrated the dysfunctional norms and conflicting ideologies that create identity struggle, disproportionally affecting women and individuals underrepresented in medicine. Symbolic interactionism can help explain identity struggles, emphasizing the influence of socio-contextual factors on identity construction. The purpose of this study was to explore how residents navigate identity struggles during residency training. We conducted a qualitative exploration of 12 residents in three specialties at three academic institutions in the United States. Participants engaged in rich picture drawings followed by one-on-one interviews. We coded transcript data and met regularly to identify themes related to residents' experiences with navigating professional identity struggles. We identified three main themes on navigating identity struggles: the weight of identity work, the isolating nature of identity work, and the navigation that occurs with and against socio-contextual currents. Residents described identity work as navigation like a boat at sea. This work felt weighty and at times overwhelming and residents often felt unable to discuss their identity struggles with others. Residents utilized what agency they had to either navigate with the current, navigating towards acceptable-albeit imperfect-paths forward, or attempting to go against the current to forge new paths through resistance. This study highlights how context enables and constrains identity construction, how contextual constraints can create dissonance between identities, and the considerable effort required to reconcile dissonance and construct professional identities. Training program adjustments, enhanced resident support, and cultural shifts are required to sustain residents' identity work. Medical professionals should engage in collective identity work to reimagine the profession's identity by addressing dysfunctional cultural norms.

Gestational Diabetes Mellitus and Subsequent Risks of Diabetes and Cardiovascular Diseases: the Life Course Perspective and Implications of Racial Disparities.

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications worldwide and the prevalence is continuously rising globally. Importantly, GDM is not an isolated complication of pregnancy. Growing evidence suggests that individuals with GDM, compared to those without GDM, have an increased risk of subsequent type 2 diabetes (T2D) and cardiovascular diseases (CVD). Substantial racial and ethnic disparities exist in the risk of GDM. However, the role of race and ethnicity in the progression from GDM to T2D and CVD remains unclear. The purpose of the current review is to summarize recent research about GDM and its life-course impacts on cardiometabolic health, including 1) the peak time of developing T2D and CVD risks after GDM, 2) the racial and ethnic disparities in the risk cardiometabolic diseases after GDM, 3) the biological plausibility and underlying mechanisms, and 4) recommendations for screening and prevention of cardiometabolic diseases among individuals with GDM, collectively to provide an updated review to guide future research. Growing evidence has indicated that individuals with GDM had greater risks of T2D (7.4 to 9.6 times), hypertension (78% higher), and CDV events (74% higher) after GDM than their non-GDM counterparts. More recently, a few studies also suggested that GDM could slightly increase the risk of mortality. Available evidence suggests that key CVD risk factors such as blood pressure, plasma glucose, and lipids levels are all elevated as early as < 1year postpartum in individuals with GDM. The risk of T2D and hypertension is likely to reach a peak between 3-6years after the index pregnancy with GDM compared to normal glycemia pregnancy. Cumulative evidence also suggests that the risk of cardiometabolic diseases including T2D, hypertension, and CVD events after GDM varies by race and ethnicity. However, whether the risk is higher in certain racial and ethnic groups and whether the pattern may vary by the postpartum cardiometabolic outcome of interest remain unclear. The underlying mechanisms linking GDM and subsequent T2D and CVD are complex, often involving multiple pathways and their interactions, with the specific mechanisms varying by individuals of different racial and ethnic backgrounds. Diabetes and CVD risk screening among individuals with GDM should be initiated early during postpartum and continue, if possible, frequently. Unfortunately, adherence to postpartum glucose testing with either obstetrician or primary care providers remained poor among individuals with GDM. A life-course perspective may provide critical information to address clinical and public health gaps in postpartum screening and interventions for preventing T2D and CVD risks in individuals with GDM. Future research investigating the racial- and ethnic-specific risk of progression from GDM to cardiometabolic diseases and the role of multi-domain factors including lifestyle, biological, and socio-contextual factors are warranted to inform tailored and culture-appropriate interventions for high-risk subpopulations. Further, examining the barriers to postpartum glucose testing among individuals with GDM is crucial for the effective prevention of cardiometabolic diseases and for enhancing life-long health.

A research need: exploring the experiences and behaviours of veiled Muslim female tourists in Western destinations

ABSTRACT Previous research has explored the dress code, behaviour, motivations, and experiences of Western and Asian female tourists during their visits to Western, Asian, and Islamic destinations. However, there is a paucity of research that explores the behaviour and perspectives of hijab-wearing female Muslim tourists when visiting Western destinations for tourism purposes. Furthermore, despite the fact that some studies have explored the experiences of Muslim women in Islamic destinations (i.e. Malysia and Turkey) there remains a significant research gap in examining the travel experiences and behaviours of veiled female Muslim tourists who visit Western destinations. This is surprising considering the significant market potential presented by Muslim women who travel to Western destinations and their patterns of consumption. This research note serves to encourage scholarly inquiry into the experiences, coping mechanisms, spatial and socio-contextual factors, and constraints faced by veiled Muslim female tourists in Western countries, while advocating for a comparative analysis with Asian and Western counterparts to facilitate a holistic comprehension of their travel experiences.

Influence of socio-contextual factors on the link between traditional and new media use, and young people’s sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis

BackgroundTraditional and new media use links to young people’s sexual risk behaviour. The social contexts of young people’s daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people’s sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa.MethodsAge-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15–24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people’s sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections.ResultsSocio-contextual factors attenuated the association between media use and young people’s sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40–2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26–2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56–0.83), p < .001), Cameroon [(aOR = 0.66 (0.51–0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56–0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49–0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29–0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries.ConclusionsMedia use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural–urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.

One-year predictors of PTSD symptoms, anxiety, and depression in SARS-CoV-2 survivors: psychological flexibility and major life events as main predictive factors.

The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae. This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson's correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online self-report questionnaires of psychosocial variables, PTSD, anxiety, and depression. Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = -0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = -0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms. Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both socio-contextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility.

Enabling and constraining factors of remote informal communication: a socio-technical systems perspective

Abstract Informal interactions are vital in daily workplace communication, shaping performance, well-being, collaboration, and overall organizational functioning. However, as the ongoing trends of remote and hybrid work present significant changes and challenges to these interactions, supporting remote informal communication (RIC) becomes urgent. To address this pressing issue, we adopt a socio-technical systems perspective to gain in-depth insights into the enabling and constraining factors related to RIC. Our findings of semi-structured interviews with working adults (N=33) reveal important changes and challenges related to informal communication in the remote work context. We identify eleven interrelated socio-contextual, intrapersonal, and technological factors, culminating in a comprehensive conceptual framework of RIC. Based on our findings, we provide practical recommendations to effectively facilitate RIC in organizations and discuss future research avenues for understanding effective RIC in organizations.

Cognitive, affective and behavioural repercussions of perceived quality in tourism vocational education: insights from self-determination theory

PurposeThis study aimed to investigate the influence of the perceived quality by students regarding their experiences in vocational schools in tourism, hospitality and food service on cognitive and affective responses (satisfaction, self-efficacy expectations and self-regulation strategies of motivation for learning - SRSML) and commitment (behavioural response).Design/methodology/approachA cross-sectional survey was conducted with 454 students from twelve Turismo de Portugal IP-affiliated schools. The theoretical framework was rooted in Self-Determination Theory (SDT) and PLS-SEM, using ADANCO 2.3 software to test the proposed model.FindingsPerceived quality by students concerning their school experiences are socio-contextual factors that directly influence their satisfaction and self-efficacy expectations (cognitive and affective responses). Satisfaction and self-efficacy expectations positively affected SRSML. Finally, satisfaction and the SRSML positively impacted the students` commitment to schools (behavioural response).Originality/valueThis study contributes to academia by comprehensively addressing 16 perceived quality dimensions within vocational education. It aligns with SDT, revealing that socio-contextual factors affect students’ cognitive, affective, and behavioural responses. Additionally, it demonstrates positive relationships between student satisfaction, self-efficacy expectations, SRSML, and students’ commitment to vocational education institutions. This study emphasises the multidimensional nature of perceived quality, urging educational institutions to address tangible and intangible dimensions to develop strategies to provide high-quality experiences, increasing students` satisfaction, self-efficacy expectations, motivation, and commitment.

Factors associated with hospitalization in a pediatric population of rural Tanzania: findings from a retrospective cohort study

BackgroundDespite pediatric acute illnesses being leading causes of death and disability among children, acute and critical care services are not universally available in low-middle income countries, such as Tanzania, even if in this country significant progress has been made in child survival, over the last 20 years. In these countries, the hospital emergency departments may represent the only or the main point of access to health-care services. Thus, the hospitalization rates may reflect both the health system organization and the patients’ health status. The purpose of the study is to describe the characteristics of clinical presentations to a pediatric Outpatient Department (OPD) in Tanzania and to identify the predictive factors for hospitalization.MethodsRetrospective cohort study based on 4,324 accesses in the OPD at Tosamaganga Voluntary Agency Hospital (Tanzania). Data were collected for all 2,810 children (aged 0–13) who accessed the OPD services, within the period 1 January − 30 September 2022. The association between the hospitalization (main outcome) and potential confounding covariates (demographic, socio-contextual and clinical factors) was evaluated using univariate and multivariate logistic regression models.ResultsFive hundred three (11.6%) of OPD accesses were hospitalized and 17 (0.4%) died during hospitalization. A higher (p < 0.001) risk of hospitalization was observed for children without health insurance (OR = 3.26), coming from more distant districts (OR = 2.83), not visited by a pediatric trained staff (OR = 3.58), and who accessed for the following conditions: burn/wound (OR = 70.63), cardiovascular (OR = 27.36), constitutional/malnutrition (OR = 62.71), fever (OR = 9.79), gastrointestinal (OR = 8.01), respiratory (OR = 12.86), ingestion/inhalation (OR = 17.00), injury (OR = 6.84).ConclusionsThe higher risk of hospitalization for children without health insurance, and living far from the district capital underline the necessity to promote the implementation of primary care, particularly in small villages, and the establishment of an efficient emergency call and transport system. The observation of lower hospitalization risk for children attended by a pediatric trained staff confirm the necessity of preventing admissions for conditions that could be managed in other health settings, if timely evaluated.

Social Determinants of Health and Informed Consent Comprehension for Pediatric Cancer Clinical Trials

Ensuring valid informed consent (IC) prior to enrollment in clinical trials is a fundamental ethical right. To assess whether social determinants of health (SDOH) and related sociocontextual factors are associated with parental IC comprehension in therapeutic childhood cancer clinical trials. This cross-sectional study prospectively enrolled 223 parents of children with newly diagnosed cancer at Rady Children's Hospital San Diego, a large quaternary academic center in California, from October 1, 2014, to March 31, 2021. Linear mixed effects models were used to assess whether IC comprehension overall and by domain (purpose, procedures, and randomization; risks and benefits; alternatives; and voluntariness) were associated with SDOH and sociocontextual factors. Data were analyzed from January 1, 2022, to July 31, 2023. Informed consent for a therapeutic childhood cancer clinical trial. The primary outcome of interest was IC comprehension and its associations with SDOH (marital status, language, educational attainment, employment, insurance type, socioeconomic status, and health literacy) and sociocontextual factors (ethnicity, satisfaction with informed consent, and cancer type). Of 223 parents, 172 (77.1%) were aged 18 to 44 years, 111 (49.8%) were Hispanic, 152 (68.2%) were women, and 163 (73.1%) were married. In terms of race, 2 (0.9%) were American Indian or Alaska Native, 22 (9.9%) were Asian or Pacific Islander, 8 (3.6%) were Black, 149 (66.8%) were White, and 42 (18.8%) were more than 1 race. In multivariable linear mixed-effects analyses, limited vs adequate health literacy was associated with lower comprehension of informed consent overall (mean [SD], 68.28 [11.81] vs 79.24 [11.77]; β estimate, -9.02 [95% CI, -12.0 to -6.07]; P < .001) and with lower comprehension of the purpose, procedures, and randomization (mean [SD], 65.00 [12.64] vs 76.14 [11.53]; β estimate, -7.87 [95% CI, -10.9 to -4.85]; P < .001); risks and benefits (mean [SD], 62.84 [20.24] vs 73.14 [20.86]; β estimate, -10.1 [95% CI, -15.6 to -4.59]; P < .001); alternatives (mean [SD], 54.27 [43.18] vs 82.98 [34.24]; β estimate, -14.3 [95% CI, -26.1 to -2.62]; P .02); and voluntariness (mean [SD], 76.52 [24.33] vs 95.39 [13.89]; β estimate, -9.14 [95% CI, -14.9 to -3.44]; P = .002) domains. Use of Spanish vs English language for medical communication was associated with lower comprehension overall (mean [SD], 66.45 [12.32] vs 77.25 [12.18]; β estimate, -5.30 [95% CI, -9.27 to -1.34]; P = .01) and with lower comprehension of the purpose, procedures, and randomization (mean [SD], 63.33 [11.98] vs 74.07 [12.52]; β estimate, -4.33 [95% CI, -8.43 to -0.23]; P = .04) and voluntariness (mean [SD], 70.83 [24.02] vs 92.54 [17.27]; β estimate, -9.69 [95% CI, -16.8 to -2.56]; P = .009) domains. In this cross-sectional study including parents of children with newly diagnosed cancer who provided IC for their child's participation in a therapeutic clinical trial, limited health literacy and use of Spanish language for medical communication were associated with lower comprehension of IC. These findings suggest that, in this setting, parents with limited health literacy or those who use Spanish language for medical communication may not fully comprehend IC and therefore may not make truly informed decisions. These findings support the investigation of interventions, across pediatric disciplines, tailored to the participant's language and health literacy level to improve IC comprehension, particularly in racial and ethnic minority populations.

Interpretive Qualitative Evaluation Informs Research Participation and Advocacy Training Program for Seniors: A Pilot Study.

Background: An 8-week educational intervention co-taught by medical students and faculty was designed to foster communication between clinical researchers and populations of interest to ultimately increase participation in clinical research by older adults, including underrepresented groups. Weekly topics focused on age-related changes and health conditions, socio-contextual factors impacting aging populations, and wellness strategies. Objectives: To evaluate the successes and weaknesses of an educational intervention aimed at increasing the participation of older adults in clinical research. Design: A focus group was assembled after an 8-week educational intervention, titled DREAMS, to obtain participants' feedback on the program, following a pre-formulated interview guide. Settings: Participants were interviewed in a health center office environment in the United States of America in April of 2016. Participants: A post-intervention focus group was conducted with a group of eight older adults (mean age = 75.8 ± 11.4 years) from 51 total participants who completed the intervention. Methods: The focus group was interviewed loosely following a pre-formed question guide. Participants were encouraged to give honest feedback. The conversation was recorded, transcribed verbatim, and analyzed using thematic analyses. Results: While participants viewed most aspects of the study as a success and stated that it was a productive learning experience, most participants had suggestions for improvements in the program content and implementation. Specifically, the composition of and direction to small breakout groups should be carefully considered and planned in this population, and attention should be paid to the delivery of sensitive topic such as death and dementia. A clear main benefit of this programmatic approach is the development of a rapport amongst participants and between participants and clinical researchers. Conclusions: The results provide useful insights regarding improving participation among hard-to-reach and historically underrepresented groups of older adults in clinical research. Future iterations of this program and similar educational interventions can use these findings to better achieve the programmatic objectives.

Chemsex and Harm Reduction Practices Among Men Who Have Sex with Men in Malaysia: Findings from a Qualitative Study

ABSTRACT Chemsex is a form of sexualized drug use commonly practiced among MSM with psychoactive substances, such as methamphetamine. While this phenomenon has gained global attention in the past two decades, there is a dearth of empirical data to inform culturally competent interventions. The current work investigates the socio-contextual factors related to chemsex and harm reduction practices among Malaysian MSM. Between February and August 2022, we conducted six online focus group sessions with Malaysian MSM who had engaged in chemsex during the previous 6 months (N = 22). We queried participants about perceived benefits and harms, harm reduction practices, and informational needs. Most participants’ first chemsex experience occurred in a casual sexual encounter, often facilitated by mobile technology. Participants reported engaging in harm reduction practices before (e.g. medication reminders), during (e.g. peer support), and after (e.g. rest) chemsex. These findings have implications for future efforts to develop and implement tailored interventions to address the specific and acute needs of Malaysian MSM engaging in chemsex.

Social Correlates of HIV-Risky Behaviours among African Canadian Adolescents Living in British Columbia, Canada: A Secondary Data Analysis.

Studies have linked HIV-risky behaviours among young people to several socio-contextual factors. However, the social factors that might increase African Canadian adolescents' exposure to HIV-risky behaviours, including unprotected sex and forced or multiple-sexual partnerships, have received little or no attention in the literature. Using data from the British Columbia Adolescent Health Surveys (2003-2018) and guided by intersectionality and socio-ecological frameworks, we examined the social determinants of HIV-risky behaviours (HRB) among African Canadian adolescents in British Columbia. We observed a general decline in HRB from 2008 to 2018. However, more than half (54.5%) of the 1042 who were sexually experienced in 2018 reported having 2 or more sexual partners, and nearly half reported condom-less sex. Our results demonstrate an important need to evaluate the impacts of several social factors on health outcomes for a unique, marginalized population.

The mental health and well-being of students and teachers during the COVID-19 pandemic: combining classical statistics and machine learning approaches

The aims of this study were to (1) to explore the state of students’ and teachers’ well-being and (2) examine the factors that predict their well-being during the pandemic-related school closures in the Philippines. Our sample comprised 733 students and 1168 teachers. During the height of the pandemic, 22.10% of the students and 13.44% of teachers met the cut-off for depression; 13.91% of the students and 15.92% of the teachers met the cut-off for anxiety. Both classical statistics and machine learning approaches were used to identify the roles of demographic, psychological, and socio-contextual factors that statistically predicted well-being outcomes. Results highlighted that family support was the strongest predictor of students’ and teachers’ positive well-being. For mental health outcomes, the strongest predictors of depression were anxiety and stress, while the strongest predictors of anxiety were depression, stress, and fear of COVID. Implications for students’ and teachers’ well-being amidst COVID are discussed.

221 Factors Influencing COVID-19 Testing among American Indians and Latinos in Two Rural Agricultural Communities: A Qualitative Study

OBJECTIVES/GOALS: Despite efforts to improve COVID-19 health outcomes through testing and vaccination, SARS-CoV-2 has exacerbated health disparities in underserved populations. Through this study we examined socio-contextual factors impacting decisions to test for COVID-19 among Native Americans in the Flathead Reservation and Hispanics in the Yakima Valley. METHODS/STUDY POPULATION: A series of 28 key informant interviews and 6 focus groups (N=39 focus group participants) were completed with community and tribal leaders using an interview guide informed by the Theory of Planned Behavior, Social Cognitive Theory, and the Social Contextual Factor Frameworks. The interview guide was designed to examine the socio-contextual factors impacting decisions to test for COVID-19 among Native Americans and Hispanics in the Northwest. A codebook was developed to apply deductive coding to informant responses, followed by an inductive, constant comparison approach. Three analysts met to refine the codebook and conduct inter-rater agreement. RESULTS/ANTICIPATED RESULTS: Five themes (social, cultural, health, religious and political factors) were identified that impacted testing for COVID-19. For social factors, participants discussed the influence of families and friends and unfair employment practices influencing decisions to test. Cultural factors included deep rooted distrust for the government and historical trauma. Health factors participants reported included the importance of testing to save lives, distrust for medical system, and health communications around COVID-19 affecting decisions to test. There was some interaction between religious and political factors. While participants mentioned beliefs in putting things in God’s hands, some decisions to test seemed to be affected by their political views. DISCUSSION/SIGNIFICANCE: Several socio-cultural factors influence decisions to test for COVID-19. Understanding the community’s perception of COVID-19 testing is critical for successful implementation of preventive strategies.

Effects of early-life environment and adulthood SES on cognitive change in a multiethnic cohort.

Early-life socioeconomic status (SES) and adversity are associated with late-life cognition and risk of dementia. We examined the association between early-life SES and adversity and late-life cross-sectional cognitive outcomes as well as global cognitive decline, hypothesizing that adulthood SES would mediate these associations. Our sample (N = 837) was a racially and ethnically diverse cohort of non-Hispanic/Latino White (48%), Black (27%), and Hispanic/Latino (19%) participants from Northern California. Participant addresses were geocoded to the level of the census tract, and US Census Tract 2010 variables (e.g., percent with high school diploma) were extracted and combined to create a neighborhood SES composite. We used multilevel latent variable models to estimate early-life (e.g., parental education, whether participant ever went hungry) and adult (participant's education, main occupation) SES factors and their associations with cross-sectional and longitudinal cognitive outcomes of episodic memory, semantic memory, executive function, and spatial ability. Child and adult factors were strongly related to domain-specific cognitive intercepts (0.20-0.48 SD per SD of SES factor); in contrast, SES factors were not related to global cognitive change (0.001-0.01 SD per year per SD of SES factor). Adulthood SES mediated a large percentage (68-75%) of the total early-life effect on cognition. Early-life sociocontextual factors are more strongly associated with cross-sectional late-life cognitive performance compared to cognitive change; this effect is largely mediated through associations with adulthood SES.

Exploring the characteristics of pre-service EFL teachers’ practicum experiences: a complexity theory-based case study in China

With increasing attention being paid to teacher education, various theoretical perspectives have been adopted to study on how pre-service teachers learn to teach. This study employed complexity theory as conceptual framework and examined two pre-service EFL teachers’ practicum experiences by qualitative case study and identified three core characteristics of their learning-to-teach: complexity, dynamism and self-organization. It is found that pre-service EFL teacher learning, as a complex system, interacted between and among a network of socio-contextual factors and thus influenced and being influenced during the learning process in a non-linear and complex way. This study made empirical and theoretical contributions to the research field of teacher education and provided implications for university-school collaboration-based teacher education practice.

Context Matters: Health Sensitivity in the Daily Lives of Older Adults Living Through the COVID-19 Pandemic.

Throughout 2021, the coronavirus disease (COVID-19) pandemic caused renewed restrictions across Germany. Given the growing evidence that the pandemic negatively affects older adults' health and well-being, this study investigated health sensitivity (emotional reactions to momentary health challenges) and its moderators (age, morbidity, perceived COVID-19 risks and worries) among older adults in their everyday lives during the second and third waves of the pandemic. Multilevel models were applied to self-reported momentary health and affect data, collected 6 times per day across 7 consecutive days in 104 participants (Mage = 76.35; range: 67-88 years), assessed between April and June 2021 (~300,000 COVID-19 cases in Germany at the time). Health sensitivity was unrelated to age and lower with higher morbidity. Importantly, older adults showed higher health sensitivity in moments when they also perceived a greater risk of contracting COVID-19. Findings suggest that sociocontextual factors related to the pandemic modulate emotional reactions to momentary health challenges, thereby underscoring the consequences of COVID-19 for older adults' emotional experiences.

Socio-contextual factors and adverse childhood experiences as determinants of substance use disorder among individuals between ages 18-40 years in Kano, Nigeria

ABSTRACT Background There is a paucity of literature on the connection between Adverse Childhood Experiences (ACEs), certain socio-contextual factors, and substance use disorder (SUD). Therefore, this study aimed at investigating the socio-contextual factors (gender, age range, educational levels, and types of settlement) and ACEs as determinants of SUD among individuals between the ages of 18-40 years in Kano, Nigeria. Methods This study used a pack questionnaire containing socio-contextual information, a 10-item Revised Inventory of Adverse Childhood Experiences, and Drug Abuse Screening Test-20 to collect data from 599-participant. Results Findings showed a high (55.3%) severe SUD (addiction problem) among the participants. Individuals with a history of ACEs (parental neglect, sexual abuse, physical abuse, and emotional abuse) scored more on SUD compared with their other counterparts. Moreover, male respondents scored higher on SUD than their female counterparts. Participants with a low level of education scored higher on SUD compared with secondary and tertiary certificate holders. However, types of settlement were not related to SUD. Conclusions Gender, age-range, educational levels, and ACEs are determinants of SUD among participants. Policymakers should organize programs that could ameliorate ACEs and low education. Also, emerging adults and males should be psycho-educated and trained to reduce substance use problems.

Urban workers' cardiovascular health due to exposure to traffic-originated PM2.5 and noise pollution in different microenvironments

The cardiovascular health of the people in urbanised cities is linked to traffic air, and noise pollution. This study investigated the cardiovascular health of people working in two microenvironments such as street (vendors) and workplace (office workers) whose blood pressure (BP) and heart rate (HR) might be affected due to regular exposure to PM2.5 and traffic noise. The PM2.5 and noise levels measurements, face-to-face questionnaire survey and health check-ups were carried out on working days from 10 A.M. to 8 P.M. in Jan-Dec 2019. The data was analysed by various statistical approaches in which the link between the traffic-borne PM2.5 and noise level at 1/3rd octave frequencies has been established with the participants' BP and HR considering the demographic, socio-contextual, habitual and annoyance perception factors. The median measure of PM2.5 and noise levels violated the WHO and NAAQS limits, i.e. 106.67 μg/m3 at street level and 33.33 μg/m3 at office indoor; and 71.35 dB (A) at the street and 65.78 dB (A) at office indoor. The results further showed that the workers working in traffic corridors had abnormally high BP and HR. The systolic BP, diastolic BP and HR values were higher than normal in male workers than female workers. The influence of low noise spectrum (50–630 Hz) was mostly observed. Therefore, the combined effect of PM2.5 > 50 μg/m3 and noise spectrum (63 and 100 Hz) > 30 dB (A) significantly affect office workers' health in traffic corridors. The hearing aids, breathing troubles in the traffic corridor and annoyance perception also influenced the BP and HR of the respondents. The results are indicative and might be helpful in urban environmental planning to improve the well-being of urban traffic corridor users.

Residential addiction treatment providers: Identifying the role of social context in worker health and turnover

Increased lethality and availability of addictive substances has strained US addiction treatment services, further exacerbating workforce shortages in these settings. The emotional and physical health toll of providing treatment may contribute to shortages. This community-initiated qualitative study aimed to identify conditions that affect provider health and turnover in residential addiction treatment from a Total Worker Health® perspective. Providers (direct service, supervisors, leaders) working in nonprofit residential treatment facilities in Massachusetts were recruited by role and geography to participate in interviews and focus groups. NVivo12 facilitated coding and analysis. 25% of transcripts were double coded to assess interrater reliability and coding consistency (mean Kappa = 0.82). Providers (N = 49) participated in 33 interviews and 4 focus groups. Many participants reported personal addiction histories. Analysis revealed how socio-contextual factors originating outside of residential facilities were dominant influences on “downstream” working conditions, worker health, staff turnover, and by extension, client care. Four primary socio-contextual themes surfaced:1) Changes in type and potency of substances and client need not reliably accompanied by shifts in treatment practices; 2) challenges balancing state requirements and state-provided resources; 3) influence of structural discrimination and addiction stigma on pay and professional advancement; and 4) geographic location of facilities shape work and quality of life. Results were used to develop a conceptual model for residential addiction treatment to illustrate pathways by which ecological factors interact to affect provider health and turnover. Findings indicate that protecting health and wellbeing of providers—many of whom are in addiction recovery themselves— is integral to improving addiction treatment. From this workforce's perspective, recent changes in socio-contextual factors have intensified already challenging working conditions (job demands, pay, advancement), negatively impacting worker health, turnover, and client care. Any interventions to improve treatment outcomes or working conditions in nonprofit addiction facilities must consider larger socio-contextual factors influencing these organizations.