Convergence Study Research Articles

Simultaneous solution of implicitly defined curved, linear Timoshenko beams in two‐dimensional bulk domains

AbstractA novel formulation of curved Timoshenko beams which are defined by all level sets of a scalar function in a two‐dimensional bulk domain is presented, including a corresponding finite element method for the simultaneous solution of these beams. The required geometrical setup and differential operators are introduced and the model is defined in strong form. The weak form for the simultaneous solution involves the co‐area formula. A crucial aspect is how the difference vector, describing the rotational deformation in this model, is discretized wherefore two different approaches are shown in this paper. Higher‐order convergence studies in the residual errors confirm that the proposed method is valid and achieves expected convergence rates.

Abstract 4147628: A Mixed Methods Analysis of Patient Knowledge in Peripheral Artery Disease

Introduction: Patient knowledge of lower extremity peripheral artery disease (PAD) is low compared to other cardiovascular diseases. Research Questions/Hypothesis: We hypothesize that demographic and socioeconomic factors impact patient knowledge of PAD. Goals/Aims: To obtain qualitative description of and identify factors associated with patient knowledge of PAD. Methods/Approach: We performed a convergent parallel mixed methods study of participants with an established PAD diagnosis. Participants completed an 87-item survey assessing demographics, awareness of PAD diagnosis, and PAD knowledge. Functional health literacy (FHL) was measured using the short Test of Functional Health Literacy Assessment. Multivariable linear regression was used to identify factors associated with PAD knowledge scores. Semi-structured interviews were used to describe understanding of PAD. Transcripts were analyzed with inductive and deductive coding, and a constant comparative approach was used to identify themes. Results/Data: There were 91 participants (77.2% response rate, 49.5% female, 29.7% Black, mean age 68.6 years). Most participants (51.7%) had chronic limb-threatening ischemia and 17.6% had a previous major amputation. While 21.3% had poor FHL and 24.4% were unaware of their PAD diagnosis, the average knowledge score was 79.1%. On bivariate analysis, non-White race, non-ambulatory status, poor FHL, lack of awareness of PAD diagnosis, and not knowing the chronicity of diagnosis were inversely associated with knowledge score. Multivariate linear regression showed that poor FHL, non-White race, and not knowing the chronicity of PAD diagnosis were independently associated with low PAD knowledge. Qualitative analysis of 22 participants revealed that patients have difficulty understanding the name “PAD”, confuse PAD with other comorbidities, and have incorrect beliefs about PAD despite high knowledge scores. Conclusions: Knowledge of PAD is associated with health literacy. However, patients have incorrect beliefs and difficulty understanding the terminology associated with PAD despite a high average knowledge score. Knowledge scores may not adequately reflect understanding. Future research will focus on optimizing patient education, identifying strategies to appropriately gauge patient understanding, and understanding the association between knowledge and behavior in PAD.

Testing the Solow Hypothesis for Fiscal Convergence: a Dynamic Spatial Analysis

The study of regional fiscal convergence is a recent extension of the neoclassical growth theory. Various studies have shown the existence of fiscal convergence across countries or states in federally governed countries. This paper tests the growth theory on income and fiscal variables differently in a centrally ruled country. Therefore, we estimate spatial and non-spatial panel models from 2004 to 2022 for Türkiye. A general-to-specific methodology is applied for selecting an appropriate model to determine spatial interactions of the variables by using the panel data at the level of 81 Turkish provinces. The Ordinary Least Squares (OLS) estimation results from the non-spatial model partially validate the growth theory as the study does not find evidence of absolute convergence for government expenditures. The results, however, confirm the conditional convergence for all variables. The Maximum Likelihood (ML) method is applied for the estimation of the dynamic and static spatial panel models to explain their spatial interactions. The ML findings are consistent with the OLS results. Moreover, unlike direct and total effects, it is not possible to define indirect effects explaining spatial spillover effects in the short and long terms.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages

BackgroundIn many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.MethodsWe carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization’s HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.ResultsA total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children’s health as poor. Many factors were associated with perceived children’s health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.ConclusionThis study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.

Developing English language learners’ speaking skills through applying a situated learning approach in VR-enhanced learning experiences

A situated learning environment is crucial for language learners to develop speaking skills as learners can apply their speaking skills in context, helping them adapt language use to various situations and improve their language proficiency and communication effectiveness. Although various features of situated learning environments have been explored across different subject areas and in many platforms, there is limited research on their application to language learning within VR environments. This convergent mixed-method study adopts a situated learning framework and examines the impact of situated learning on learners’ English-speaking performance, specifically in areas of fluency, vocabulary, pronunciation, and grammar, and explores learners’ perception of the instruction based on the situated learning approach. Sixteen first-year English majors at a university in China participated in eight role-play speaking classes using the desktop-based VR application, Immerse. The study involved pre- and post-assessments of speaking performance and semi-structured interviews with six participants. Paired samples t-tests were used to assess the difference in the speaking performance and respective areas, and a thematic analysis was adopted to explore learners’ perceptions of the instruction based on the situated learning approach. Quantitative findings show a significant improvement in learners’ speaking performance (t(15) = 7.41, p < .001, Cohen’s d = 1.82), with notable progress in fluency, vocabulary, pronunciation, and grammar. Thematic analysis of the qualitative data indicated the authenticity of the context and activities, the collaborative nature of the tasks, the expert guidance, and the opportunities for reflection all contribute to a comprehensive learning experience that aligns well with the principles of situated learning.

Stakeholder Perspectives on a Heart Failure With Reduced Ejection Fraction Polypill: A Multi-Center Mixed Methods Study.

A polypill containing all 4 classes of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) has been proposed to change the heart failure treatment paradigm. The acceptability, appropriateness, and feasibility of a HFrEF polypill-based strategy are unknown. The purpose of this study was to elicit patients' and providers' priorities in the design of HFrEF polypills. From April 2023 to December 2023, we conducted a convergent parallel mixed-methods study at Washington University in St. Louis, the University of California, San Francisco, and the American College of Cardiology. We administered physician surveys containing adapted implementation outcome measures to elicit physicians' perspectives on the acceptability, feasibility, and appropriateness of a HFrEF polypill (Likert scale ranging from 1 [low] to 5 [high]). We used a purposive sampling frame to select patients and physicians for in-depth interviews. Using semi-structured interview guides, we elicited participants' perspectives on current HFrEF care, HFrEF polypill design, and supportive strategies. The Consolidated Framework for Implementation Research v2.0 guided thematic analysis. Of the 214 survey respondents across the United States, physicians agreed that HFrEF polypills are highly acceptable (mean [SD], 4.2 [0.7]), highly appropriate (4.1 [0.8]), and highly feasible (4.1 [0.7]). Key themes from 9 patient and 22 provider interviews included the following: (1) current determinants of HFrEF care, including medication adherence, variations in clinical practice, and health care access, (2) provider-level differences in preferred HFrEF polypill design, (3) cost and equity considerations in the implementation of HFrEF polypills, and (4) research priorities for evaluating polypill effectiveness and implementation. A HFrEF polypill-based strategy was viewed as highly acceptable, appropriate, and feasible by patients and physicians. Participants described key priorities in HFrEF polypill design, titratability, and potential impacts on health equity that will directly inform future randomized controlled trials.

An exploration of patient safety culture in NICUs: a convergent parallel mixed-method study

BackgroundSafety culture, as a component that improves the quality of safety and health care for neonates, serves as foundation for providing professional and high-quality care by creating positive insight among employees. This study aimed to explore the safety culture concept in neonatal intensive care units (NICUs).MethodsThis convergent parallel mixed-method study included Quantitative, Qualitative, and Integrated parts. In the Quantitative part, the psychometric properties of the Persian version of “Hospital Survey on Patient Safety Culture” were examined among physicians and nurses in NICUs. CFA was performed on the data obtained from 342 participants. The Qualitative section data were collected through in-depth and semi-structured interviews with 24 staff to understand the concept of safety culture. Data were analyzed through the Elo & Kyngäs approach. The interpretation of the results and the convergence of the data was done using the Onwuegbuzie and Teddlie method.ResultsThe initial CFA showed that the 12-dimensional model did not align well with indices. Subsequently, based on T-values, six heterogeneous items were eliminated. The revised 11-dimensional model consisting of 36 items showed an acceptable fit during the second CFA. In the qualitative part, five main categories of “Constructive interactions”, “Management’s commitment to neonatal safety”, “Organizational supportive climate”, “Professional development”, and “Planning and implementation of neonatal developmental care” were obtained. The comparison of the results showed that the dimensions of the quantitative part, except for “Overall perceptions of patient safety”, were also present in the qualitative part, but they were different in some aspects. New findings in the qualitative study such as “Striving for mutual empowerment”, “Constructive criticism in teamwork”, “Efficient supervision procedures”, “Inexperienced staff’ leading” and “Provision of care assistance equipment and facilities” were not found in the dimensions of the quantitative part. The main categories “Acquiring professional competence” and “Planning and implementation of neonatal developmental care” were not align with the dimensions identified in the quantitative study.ConclusionThe findings shed light on previously unexplored aspects of the safety culture concept within the nursing profession, leading to a better understanding and evolution of this concept in Iranian NICUs. The new definition obtained in this study can enhance nursing knowledge on safe care and improve patient safety culture in the NICUs in Iran and globally.

Effects of Qualitative Interview Participation on Muslim American Identity Integration: A Mixed-Method Investigation

ABSTRACT Participation in research studies about one’s identity has been found to act as a form of counseling intervention. This mixed-method convergent parallel design study sought to examine whether participating in a 45-minute one-on-one semi-structured interview on Muslim American identity integration affected participants’ views of their identity one year later. Participants included 29 ethnically diverse second-generation Muslim Americans residing in the U.S. Midwest who were retained at one-year follow-up from a semi-structured identity interview of 53 participants. Participants completed a survey with measures of identity, identity integration, and open-ended questions inquiring how the study influenced them. Descriptive quantitative analyses and thematic analysis of qualitative data were used to examine the participants’ perceptions of the interview. Qualitative responses displayed five themes (Self-Understanding and Reflection, Affirmation, Connecting With In-Group, “Normal” Conversation Topic, and No Change) aligning with the three primary domains incorporated in ethnic identity development. The blendedness of the participants’ Muslim and American identities, American centrality, and participants’ self-reported positive private regard toward their American identity were lower at Time 2 compared to Time 1. More research is needed regarding the influence of participating in identity-based mixed-methods studies on Muslim American identity formation.

Buckling analysis of single‐walled carbon nanotubes using the initial value method and approximate transfer matrix based on nonlocal elasticity theory

AbstractIn this study, a novel method is presented to analyze the buckling behavior of single‐walled carbon nanotubes (SWCNTs) using the initial value method (IVM) in conjunction with the approximate transfer matrix, within the framework of nonlocal elasticity theory. The study aims to accurately approximate critical buckling load parameters under various boundary conditions, without encountering high computational requirements. IVM enables the computation of displacements and stress resultants along the entire beam from given initial conditions. The approximate transfer matrix is employed to analyze system states at different points through successive integration of solutions, generating the principal matrix needed for IVM and ensuring systematic and precise results that optimize the accuracy of the analysis. A convergence study confirms the effectiveness and precision of the proposed method, revealing a decrease in the critical buckling load parameters as the nonlocal parameter increases, applicable across all boundary conditions studied (simply supported, clamped–clamped, clamped–simply supported, and clamped‐free). These results underscore the need to incorporate nonlocal effects for more accurate nanostructure mechanics predictions. The integration of IVM and the approximate transfer matrix provides a computationally efficient alternative to traditional numerical and semi‐analytical methods, aiding researchers and engineers working with SWCNTs and other nanomaterials.

Benchmark Simulation of Laminar Reactive Micromixing Using Lattice Boltzmann Methods

Micromixers are chemical processing devices with complex flow patterns applied for both mixing and reaction of chemical species. In current research, laminar reacting multicomponent flows are considered. Despite the laminar streaming regime (e.g., Re = 186), there exist secondary flow microstructures. For this setup, accurate predictions of those structures are possible with a large-eddy simulation on a fine mesh resolving till the Batchelor microscales. Utilizing the open-source lattice Boltzmann method (LBM) framework, OpenLB, a benchmark simulation of the reacting micromixer, is re-established with new, more precise computation results. In this context, a Schmidt-number-based stabilization method for LBM-discretized reactive advection–diffusion equations by laminar secondary flow structures is used. A convergence study is performed, which is also a novelty. All computations have been performed on the high-performance computing cluster HoreKa using up to 160 NVIDIA A100 graphics processing units.

Implementing universal maternal depression screening in head start: A convergent mixed methods study

AimsImplementing maternal depression screening in child-serving programs can help ensure that more mothers receive mental health services. This study examined the implementation of universal maternal depression screening in community-based Head Start programs. MethodsQuantitative and qualitative data were merged in a convergent mixed method design to assess four domains from the RE-AIM implementation science framework (Reach, Adoption, Implementation, and Maintenance). Qualitative data included interviews with stakeholders and meeting minutes from the implementation period. Quantitative data included intervention outcomes and administrative data. ResultsIn terms of reach, 85% of eligible Head Start mothers were screened for depression, and English-speaking mothers were more likely to refuse screening than Spanish-speaking or bilingual mothers. Barriers to screening included lack of availability, stigma, privacy concerns, lack of interest, and lack of trust. In terms of adoption, all sites and staff adopted screening due to organizational mandates. In terms of implementation, there was wide variation in rates of positive screenings across staff completing the screening (ranging from 0% to 46%), and barriers included concerns about staff role and lack of training. In terms of maintenance, screening was not sustained after the study period due to organizational priorities and lack of buy-in from staff. ConclusionUniversal maternal depression screening has the potential to reach low-income Head Start mothers, but additional efforts should be made to build staff capacity to engage mothers in screening.

An Analysis of SRSS-IE Externalizing Cut Scores to Facilitate Data-Informed Decision-Making in K–12 Schools

We report the results of a convergent validity study examining the externalizing subscale (SRSS-E5, five items) of the adapted Student Risk Screening Scale for Internalizing and Externalizing (SRSS-IE 9) with the externalizing subscale of the Teacher Report Form (TRF) with two samples of K–12 students. Results of logistic regression and receiver operating characteristic curves analyzed with a sample of 195 K–5 students from 13 schools across three states suggested the following preliminary cutting scores for the SRSS-E5 for use at the elementary level: 0 to 1 for low risk, 2 to 3 for moderate risk, and 4 to 15 for high risk for externalizing behaviors. Results of the same analyses with a sample of 227 students in Grades 6 to 12 suggested the following preliminary cutting scores for the SRSS-E5 for use in middle and high (secondary) schools: 0 to 4 for low risk, 5 to 6 for moderate risk, and 7 to 15 for high risk for externalizing behaviors. For both samples, sensitivity and specificity levels were acceptable, as was the correct classification rate. We discuss findings and limitations and emphasize the importance of replication before shifting screening practices from the SRSS-IE 12 (12 items) to the newly adapted SRSS-IE 9 (9 items).

Exploring the Association Between Loneliness, Subjective Cognitive Decline, and Quality of Life Among Older Thai Adults: A Convergent Parallel Mixed-Method Study.

Examining the rising prevalence of subjective cognitive decline as an early indicator of dementia in adults, this study investigates its complex interaction with loneliness and quality of life in individuals with preclinical dementia. Using a convergent parallel mixed-method approach, we employed Structural Equation Modeling on a cohort of 149 older adults. Qualitative insights were derived from focused group discussions and in-depth semi-structured interviews with a cohort of 23 older adults. Loneliness emerges as a pivotal contributor, exerting a discernible partial indirect effect on quality of life through subjective cognitive decline (indirect effect = -0.145, p = .006). Noteworthy differentials surfaced, with the impact of subjective cognitive decline on quality of life heightened in those with chronic diseases (△χ2 = 6.139, p = .013). Loneliness, wielding a palpable impact, intricately interlaces with quality of life, the nexus of which is intricately mediated by subjective cognitive decline.

Expectations and needs of gynecological cancer survivors at the end of primary cancer treatment: A convergent mixed methods study

Objectif : Les survivantes d’un cancer gynécologique souhaitent bénéficier d’interventions de soutien holistiques et axées sur la personne pour répondre aux besoins non satisfaits après le traitement. L’élaboration de ce genre d’interventions nécessite de comprendre à la fois les attentes et les besoins des survivantes de cancer gynécologique. L’objectif de la présente étude était de comprendre les attentes et les besoins des survivantes de cancer gynécologique après le traitement, et d’examiner comment ces attentes et ces besoins convergent et divergent afin d’orienter les soins. Méthodologie : L’étude faisait appel à un devis convergent à méthodes mixtes (qualitative+quantitative) parallèles. Les données qualitatives ont été recueillies lors d’entrevues téléphoniques individuelles. Les données quantitatives ont été recueillies à l’aide du questionnaire sur les besoins non satisfaits des survivants au cancer (Cancer Survivors’ Unmet Needs). Résultats : En tout, 24 personnes ont participé à l’étude. Les attentes des survivantes par rapport à la période post-traitement comprenaient deux catégories d’interventions (tant pour la mise en œuvre que pour les résultats) : la lutte contre l’inconnu et l’information fiable pour renforcer les capacités. Les besoins non satisfaits les plus courants touchaient l’aspect existentiel de la survivance; toutefois, l’analyse à méthodes mixtes a révélé que les participantes s’attendaient surtout à ce que les interventions post-traitement comblent leurs besoins informationnels. Conclusion : Les conclusions mettent en lumière les attentes et les besoins des survivantes de cancer gynécologique après le traitement, de même que l’importance d’analyser le moment où il convient de planifier les soins et de les dispenser. Les cliniciens pourront utiliser ces conclusions pour concevoir et raffiner les interventions visant à répondre aux besoins non satisfaits des survivantes de cancer gynécologique.

An Unstructured Mesh Coordinate Transformation‐Based FDTD Method

ABSTRACTWe propose a novel unstructured mesh finite‐difference time‐domain (FDTD) method for solving electromagnetics problems with complicated geometries. The method, which solves the TE‐mode reduced form of Maxwell's equations, can handle both material interfaces and anisotropic material. Using the transformation optics principle, which describes how fields and material tensors change under coordinate transformations, we locally transform each cell in the mesh to a reference unit‐square computational domain where the usual FDTD update is performed. This comes at a cost: employing unstructured grids and coordinate transformations requires more complicated data structures, a mesh orientation process, and potentially introduces an anisotropic material tensor at every mesh cell. Nonetheless, we find that the method maintains the same desirable properties of the classic FDTD method (explicit, divergence‐free B‐field, nondissapative, and second‐order accuracy) while also gaining conforming material interfaces and boundaries in complicated geometry. Even further, we prove that the method is stable under a Courant condition and a fairly nonrestrictive mesh condition, hence defeating the late‐time stability issue plaguing prior nonorthogonal FDTD methods. To verify the method, we conduct convergence studies on three electromagnetic cavity problems with known exact solutions. For these numerical studies, we find that the method maintains second‐order convergence and stability.

Triple junction benchmark for multiphase-field models combining capillary and bulk driving forces

Abstract A benchmark problem is formulated which is well suited for the validation of mesoscopic phase-field models for grain-boundary migration in polycrystals. First, an analytical steady-state solution of the sharp moving boundary problem is derived for a symmetric lamellar structure, which is valid for arbitrary bulk driving forces and triple junction angles. Characteristic quantities are identified to reduce the parameter space which in turn allows a systematic comparison of simulations and analytical results. Various multiphase-field (MPF) formulations are compared which approximate the sharp interface problem in terms of a diffuse regularization. An interfacial thickness convergence study reveals that the model error is largely dependent on the ratio of bulk to interfacial stabilizing force as well as the underlying model formulation. An additional grid convergence study highlights the efficiency of a more advanced discretization scheme. The results can be used to guide the selection of appropriate models and to estimate the interface thickness and spatial resolution required to achieve a given accuracy target. The post-processing framework consists of a fully automated determination of well-defined metrics from the phase field simulation data, eliminating human bias and facilitating reproducibility. The corresponding code is made openly available to assist the materials science and engineering community in validating MPF, multi-order parameter and similar model developments. We believe that this work provides a reliable benchmark procedure to better understand the potentials and limitations of current multiphase-field models as well as alternative approaches.

Dietary practices and associated factors among adult diabetic patients at academic tertiary-level hospitals in central Ethiopia: convergent mixed study

BackgroundDiabetes mellitus (DM) is one of the most prevalent chronic diseases worldwide. Despite the existence of national strategies to prevent potential complications, DM-related morbidities and mortality continue to rise in Ethiopia. Although studies have been conducted regarding dietary practices among DM patients in the country, there is a lack of in-depth understanding of the situation.ObjectiveTo assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia in 2024.MethodsA concurrent mixed-methods study was conducted from January 01 to 30, 2024, involving 420 adult DM patients. Participants were selected using a simple random sampling technique for the quantitative study. A purposive sampling technique was used to select sixteen participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and in-depth interviews were conducted for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data.ResultOf 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (42.4%). Being female, residing in urban areas, having a family history of DM, and having good dietary knowledge were significantly associated with better dietary practices. From the qualitative analysis, two themes emerged "Living as before and not adhering to diabetic dietary recommendations" and "Barriers to adherence to effective eating practices."Conclusions and recommendationsLess than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended.

L2 Learners’ Perspectives on Data-Driven Learning for Identifying Properties of Near-Synonymous Words: A Convergent Mixed-Methods Study

This study examines second language (L2) learners’ perspectives regarding the affordances and challenges of using the Data-Driven Learning (DDL) to identify the properties of near-synonymous words. Employing a convergent mixed-method design, this study deciphers the perceptions of 40 undergraduate L2 learners majoring in English language teaching. After an initial identification of the learners’ vocabulary levels, the experienced benefits and barriers associated with carrying out experiential tasks were elicited via questionnaire data and open-ended survey questions. Descriptive statistics, including means and standard deviations, were revealed and thematic analyses of the responses to the survey questions were documented. The results indicate that completing tasks through the corpus was found to enhance their knowledge of collocations. Integrating corpus tasks into YouGlish (an online practice tool for authentic spoken English in context) was found to increase their awareness of the contextual properties of words. The identification of condensed language exposure, lexical inference, and elicitation of flexible and context-specific patterns were reported to be beneficial. Acknowledging these benefits, gaining familiarity with the corpus interface, encountering limited access to search queries, and analyzing large amounts of concordance lines posed challenges for learners. This research presents the implementation of the DDL supported by experiential learning, contextually rich input, and inductive reasoning tasks in vocabulary learning by further offering instructional implications in L2 contexts.

Evaluating the feasibility of an Adapted Physical Activity intervention among breast cancer patients

Abstract Adapted physical activity (PA) programs have shown promising results to reduce physical, psychological and social side effects associated with breast cancer (BC), but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to evaluate RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime), an innovative intervention focused on improving the quality of life (QoL) of BC surgery patients through fencing. A convergent mixed-methods pilot study was conducted to evaluate the RE-AIM dimensions of RIPOSTE. 24 participants who have just undergone surgery for invasive BC were randomly allocated either in the “RIPOSTE” group (starting immediately after their inclusion), or the “Delayed RIPOSTE” group (starting at 3 months following their inclusion). They answered to questionnaires at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and PA. Interviews were conducted with 10 participants, 3 sports physicians and 1 fencing master. RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of health indicators, even without any significant differences between the two groups. The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during vacations were the main barriers. Maintenance analyses showed that most participants continued to practice PA after the program. RIPOSTE is an acceptable and effective program for involving BC survivors in PA, that needs to be tested at larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide. Key messages • These results would help to enrich the literature on how to best intervene to enhance treatment and recovery among patients and facilitate transfer from a research program to a field daily practice. • By highlighting complexities of RIPOSTE effectiveness and implementation, this study could lead to a more complete program that addresses issues related to improving external and internal validity.

Cultural Adaptation of RUBI Intervention with Korean Families(K-RUBI): A Mixed Method Study.

Challenging behaviors of young autistic children remain a major parenting challenge for many of their family members, including caregivers. Caregivers from underrepresented cultural or linguistic backgrounds may experience exacerbated difficulties related to challenging behaviors due to limited access to culturally sustaining and responsive interventions. Evidence-based behavior parent training programs, such as RUBI, are highly effective in increasing caregivers' capacity in preventing and responding to these behaviors in naturalistic settings using behavior analytic principles. Therefore, the purpose of this study was to examine the effectiveness, acceptability, and feasibility of the culturally adapted RUBI program with underserved families. We conduct a convergent mixed-methods study using a pilot randomized controlled trial with a waitlist control group and focus group interviews with 31 Korean families of young children with or suspected of autism. The Korean RUBI underwent rigorous cultural adaptation using the Cultural Adaptation Checklist, including the use of multiple community advisory boards to inform cultural adaptation. Both quantitative and qualitative findings revealed significant improvements in parents' confidence and knowledge in behavioral principles and decrease in severity of challenging behaviors, which suggest clinical utility of RUBI in an underrepresented, low-resourced community. A culturally adapted intervention for a different population can be perceived as a newly constructed intervention. This study provides insight on the systematic process of cultural adaptation of an established autism intervention and effectiveness, feasibility, and acceptability of RUBI.