Childhood sexual abuse and antiretroviral therapy adherence among older adults living with HIV: a mixed methods study.

Findings on the association between childhood sexual abuse (CSA) and antiretroviral therapy (ART) adherence have been varied, with some studies showing a relationship, or a lack thereof. However, to our knowledge, no study has examined this association among older adults living with HIV (OALH). Therefore, the purpose of this study was to examine the association between CSA and ART adherence among OALH using a mixed methods approach. This study, which involved a concurrent design, had two phases. The first phase comprised in-depth, semi-structured interviews of 24 adults aged 50 and older living with HIV in South Carolina. The second phase included data from 91 OALH. Thematic analysis and multivariable regression models, adjusting for age, gender, race, and income, were used to determine the association between CSA and ART adherence. The main theme emerging from the qualitative data was that CSA was not linked with ART adherence. However, contrastingly, quantitative analyses revealed a negative statistically significant association between CSA and ART adherence (adjusted ß: -3.35; 95% CI: -5.37, -1.34). This difference in findings could be due to the hidden impact of trauma and/or the use of different study populations. Future research should assess mediating pathways between CSA and ART adherence.

Care Transition From the Perspectives of Oncological Patients and the Multiprofessional Care Team: A Mixed Methods Study.

BACKGROUND: Integration into the health system is essential for safe care and efficient use of resources. OBJECTIVES: The aims of this study were to analyze the transition of care from the perspective of adult patients with neoplasia of the digestive tract and the multiprofessional care team, identify factors that influence the transition of care, and, collectively with professionals, create actions to improve the transition of care at the study site. METHODS: The Care Transitions Measure-15 was administered in a mixed methods study, with a QUAN→QUAL sequential explanatory approach. The principles of deliberative dialogue were used as a knowledge translation strategy, and data integration was carried out. RESULTS: The average score of the Care Transitions Measure-15 considered satisfactory was 74.3. The care plan factor had an unsatisfactory score of 66. Strategies to improve the care transition were listed by the focus group participants, such as supplementary care protocol for patients with neoplasms of the digestive tract, and providing a single discharge plan containing all information relevant to the treatment and continuity of patient care. CONCLUSION: The low score for the care plan factor indicates weakness in the care transition. IMPLICATIONS FOR PRACTICE: The integrated analysis results indicated that the care transition can be improved by an educational process during discharge planning, implementation of protocols for patients with neoplasia of the digestive tract, and identification of a reference caregiver to help patients navigate the healthcare system.

Changes in perceptions of teaching quality in secondary schools in Rwanda during the COVID-19 global pandemic and the subsequent closing and reopening of schools.

The stability of measures of teaching quality is essential for making generalizations of results stemming from these measures to other teaching situations. However, no research has examined the effects of unexpected situational factors on the stability of these measures. Therefore, the purpose of this two-phase quantitative research study was to examine the following aspects among secondary school teachers in Rwanda, using a score-validated, multiple-dimension measure: (a) perceptions of teaching quality (PTQ) prior to the onset of the COVID-19 context (Phase 1; descriptive and correlational design); and (b) the extent to which COVID-19 and the subsequent closing and reopening of secondary schools affected PTQ among STEM teachers in Rwanda, and the associations between these changes in PTQ and selected socio-demographic/locational variables (Phase 2; descriptive and correlational research design). Phase 1 findings revealed that two measures of cultural values (i.e., Attitudes Towards Cultural Values Scale, Inculcating Cultural Values Scale, respectively) generated the most positive attitudes, whereas the Satisfaction with Resources and Material Subscale yielded the least positive attitudes. Phase 2 findings revealed that for four of the nine PTQ scales/subscales, the COVID-19 context negatively affected PTQ. These findings provide compelling evidence of the importance of monitoring PTQ, especially during times of crises. Moreover, these findings have implications for Rwandan educational policymakers, Rwandan administrators, teacher training administrators, and, above all, the teachers themselves, as they all seek to maximize teaching quality in Rwandan secondary schools.

Emotion differentiation and negative emotional states: the mediating role of perceived academic control and the moderated effect of intrinsic motivation.

University students experience academic pressure, fatigue, and changes in their everyday and social lives during their transition into college. This study explored variables that influenced first-year students' stress, anxiety, and depression at a university in Chile. The remnant of long-term social unrest, which emerged at the end of the dictatorship in 1990, has lasted for more than three decades. It is present in the education sector and might reflect the negative emotional states that Chilean students still experience. In this way, students' capacity to distinguish and to regulate stress, anxiety, and depression is crucial, especially in contexts where intense negative emotional states occur; thus, more research is needed to achieve a richer understanding in academic settings. The study involved testing hypotheses over 6 months to undertake a regression-based path analysis using simple mediation and moderated mediation analysis. Results revealed that students' perceptions of their academic control mediated the relationship between their factor differentiation of emotional experiences and stress, anxiety, and depression. The indirect effect was statistically significantly moderated by intrinsic motivation. Consequently, the effect of their ability to differentiate emotions on stress, anxiety, and depression through the mediator changed due to the levels of intrinsic motivation. Implications and recommendations are discussed.

The Specificity of Observational Studies in Physical Activity and Sports Sciences: Moving Forward in Mixed Methods Research and Proposals for Achieving Quantitative and Qualitative Symmetry.

Mixed methods studies are been increasingly applied to a diversity of fields. In this paper, we discuss the growing use-and enormous potential-of mixed methods research in the field of sport and physical activity. A second aim is to contribute to strengthening the characteristics of mixed methods research by showing how systematic observation offers rigor within a flexible framework that can be applied to a wide range of situations. Observational methodology is characterized by high scientific rigor and flexibility throughout its different stages and allows the objective study of spontaneous behavior in natural settings, with no external influence. Mixed methods researchers need to take bold yet thoughtful decisions regarding both substantive and procedural issues. We present three fundamental and complementary ideas to guide researchers in this respect: we show why studies of sport and physical activity that use a mixed methods research approach should be included in the field of mixed methods research, we highlight the numerous possibilities offered by observational methodology in this field through the transformation of descriptive data into quantifiable code matrices, and we discuss possible solutions for achieving true integration of qualitative and quantitative findings.

Effects of a Comprehensive, Multiple Risky Behavior Prevention Program on High School Students.

The purpose of this research study was to examine the effect of a multiple risky behaviors prevention program applied comprehensively throughout an entire school system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The noncurriculum prevention program was created based upon the key elements of effective prevention programming and the need to address the growing variety of risky behaviors that the youth face today. Results (n = 469 to 614) indicated that 7 out of 15 risky behaviors statistically significantly decreased throughout the 4-year study, with 6 behaviors involving alcohol and drugs. However, many of the targeted non-substance-use risky behaviors displayed inconsistent prevalence rate patterns without statistically significant changes. These findings indicate that the frequency and intensity of programming for non-substance-use behaviors should be increased to a value at least equal to that of the substance-use behaviors. Implications for schools, prevention specialists, and future program development and research are discussed.

Use of design effects and sample weights in complex health survey data: a review of published articles using data from 3 commonly used adolescent health surveys.

OBJECTIVES: We assessed how frequently researchers reported the use of statistical techniques that take into account the complex sampling structure of survey data and sample weights in published peer-reviewed articles using data from 3 commonly used adolescent health surveys. METHODS: We performed a systematic review of 1003 published empirical research articles from 1995 to 2010 that used data from the National Longitudinal Study of Adolescent Health (n=765), Monitoring the Future (n=146), or Youth Risk Behavior Surveillance System (n=92) indexed in ERIC, PsycINFO, PubMed, and Web of Science. RESULTS: Across the data sources, 60% of articles reported accounting for design effects and 61% reported using sample weights. However, the frequency and clarity of reporting varied across databases, publication year, author affiliation with the data, and journal. CONCLUSIONS: Given the statistical bias that occurs when design effects of complex data are not incorporated or sample weights are omitted, this study calls for improvement in the dissemination of research findings based on complex sample data. Authors, editors, and reviewers need to work together to improve the transparency of published findings using complex sample data.

Methodological reporting in qualitative, quantitative, and mixed methods health services research articles.

OBJECTIVES: Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of methodological components indicative of rigorous approaches across mixed methods, qualitative, and quantitative articles. DATA SOURCES: All empirical articles (n = 1,651) published between 2003 and 2007 from four top-ranked health services journals. STUDY DESIGN: All mixed methods articles (n = 47) and random samples of qualitative and quantitative articles were evaluated to identify reporting of key components indicating rigor for each method, based on accepted standards for evaluating the quality of research reports (e.g., use of p-values in quantitative reports, description of context in qualitative reports, and integration in mixed method reports). We used chi-square tests to evaluate differences between article types for each component. PRINCIPAL FINDINGS: Mixed methods articles comprised 2.85 percent (n = 47) of empirical articles, quantitative articles 90.98 percent (n = 1,502), and qualitative articles 6.18 percent (n = 102). There was a statistically significant difference (χ(2) (1) = 12.20, p = .0005, Cramer's V = 0.09, odds ratio = 1.49 [95% confidence interval = 1,27, 1.74]) in the proportion of quantitative methodological components present in mixed methods compared to quantitative papers (21.94 versus 47.07 percent, respectively) but no statistically significant difference (χ(2) (1) = 0.02, p = .89, Cramer's V = 0.01) in the proportion of qualitative methodological components in mixed methods compared to qualitative papers (21.34 versus 25.47 percent, respectively). CONCLUSION: Few published health services research articles use mixed methods. The frequency of key methodological components is variable. Suggestions are provided to increase the transparency of mixed methods studies and the presence of key methodological components in published reports.

Reading ability and computer-related attitudes among African American graduate students.

This study examined the degree that African American graduate students' reading abilities predict their attitudes toward computers and the educational use of the Internet. A canonical correlation analysis revealed that students with the lowest levels of reading ability tended to report the least computer confidence, least positive attitudes regarding computer liking, and least positive attitudes toward the educational use of the Internet. Findings of the study provide support for the hypothesis that reading ability differentially impacts African American graduate students' computer-related attitudes. The findings also suggest that reading ability may impede African American students' acquisition of computer and Internet skills and may negatively impact their achievement levels in graduate courses requiring computer-based skills.

Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada).

OBJECTIVE: Children and adolescents of the Gaza Strip have been subjected to continuous violence since the eruption of the second Intifada (Uprising). Little is known, however, about the psychological effects of this violence on children and adolescents of Gaza. Thus, the purpose of the present investigation was to evaluate and describe the psychological effects of exposure of war-like circumstances on this population. METHOD: Participants for this study were 229 Palestinian adolescents living in the Gaza Strip who were administered measures of post-traumatic stress disorder (PTSD), depression, anxiety, and coping. RESULTS: Of the 229 participants, 68.9% were classified as having developed PTSD, 40.0% reported moderate or severe levels of depression, 94.9% were classified as having severe anxiety levels, and 69.9% demonstrated undesirable coping responses. A canonical discriminant analysis revealed that adolescents diagnosed with PTSD tended to be those who reported the highest levels of depression, anxiety, and positive reappraisal coping, and the lowest levels of seeking guidance and support coping. CONCLUSIONS: These results indicate that a significant proportion of Palestinian adolescents living in the Gaza Strip are experiencing serious psychological distress.

The scope of sexual, physical, and psychological abuse in a Bedouin-Arab community of female adolescents: The interplay of racism, urbanization, polygamy, family honor, and the social marginalization of women.

OBJECTIVES: This is an exploratory study of the abuse-especially sexual-of female adolescents in a conservative and traditional Bedouin-Arab community in southern Israel. The objectives were (1) to examine the rate of sexual abuse, (2) to examine the rate of physical and psychological abuse, and (3) to develop regression models to predict these forms of abuse. METHODS: : A self-administered survey that measured demographic characteristics and psychological abuse was distributed to 217 female high-school students (aged 14-18 years). Sexual and physical abuse were measured via the Finkelhor's scale [Finkelhor, D. (1979). Sexually victimized children. New York: Free Press]. RESULTS: Sixty-nine percent of the participants (n=149) reported no sexual abuse experiences, 16% reported one or two experiences, 11% reported three or four, and 4% reported more than four. Most participants indicated that they had been physically abused at least once by their father (37.1%), mother (43.7%), or siblings (44%) during the previous month. More than 50% of the participants reported being psychologically abused by members of their immediate families. Mother's age and closeness to mother significantly predicted physical abuse, and marital satisfaction and mother's age significantly predicted psychological abuse. CONCLUSION: This study addresses a topic that has never before been fully investigated--the maltreatment of females in a conservative, tribal Arab community. Although this was an exploratory study, the results attest that female abuse is a serious social problem in this community, and that the rate of abuse exceeds that of other Palestinian groups. These findings demonstrate an immediate need for professional intervention and prevention to address this problem.

Attributions toward violence of male juvenile delinquents: a concurrent mixed-methodological analysis.

The authors investigated male juvenile delinquents' causal attributions about others' behavior and the salient pieces of information that the male juveniles used in arriving at their attributions. Participants were 82 male juvenile offenders whom the authors drew randomly from the population of juveniles who were incarcerated at a correctional facility. A concurrent mixed-methodological analysis revealed that the juvenile offenders committed attributional errors about violence nearly 53% of the time. Race and number of prior arrests predicted the number of attributional errors about violence. A phenomenological analysis revealed the following 7 themes stemming from juveniles' reasons for causal attributions: self-control, violation of rights, provocation, irresponsibility, poor judgment, fate, and conflict resolution. Some of these themes were related to age, ethnicity, and number of prior arrests. The authors discussed implications of all findings.

Behavioral problems and scholastic adjustment among Bedouin-Arab children from polygamous and monogamous marital family structures: some developmental considerations.

Families in the Bedouin-Arab community in Israel are characterized by monogamous and polygamous marriages. Such diversity in family structure occurs in other parts of the world, yet scant empirical evidence exists to refute or to support the claim that polygamous family structure can be a risk factor for children's school maladjustment and negative developmental outcomes. The purpose of the current study was to test this claim. Participants were 255 3rd-grade children from the Negev Bedouin community in Israel. One hundred fifty-three children came from monogamous families that were characterized by 1 wife (i.e., 1-wife families), and 102 children came from polygamous families consisting of 2 wives (i.e., 2-wife families). Teachers completed the Teacher's Report Form of the Child Behavior Checklist (T. M. Achenback, 1991b). A series of logistic regression analyses, after adjusting for maternal education level, revealed that 2-wife children tended to have higher levels of externalizing problems in general and higher levels of attention problems in particular than did their 1-wife counterparts. Also, 2-wife children had higher rates of school absenteeism and lower levels of overall academic achievement than did 1-wife children. Implications for the Bedouin society are discussed.

The effect of polygamous marital structure on behavioral, emotional, and academic adjustment in children: a comprehensive review of the literature.

Polygamy represents expanded family structures that are based on marriages involving a husband with 2 or more wives. Interestingly, polygamy is legally and widely practiced in 850 societies across the globe. In the last 2 decades, polygamy has been the focus of a significant growth in public, political, and academic awareness. Indeed, several quantitative and qualitative research articles and theoretical papers have emerged during this period, particularly concerning the effects of this form of marital structure on behavioral, emotional, and academic adjustment of children. However, to date, no researcher has provided a summary of the extant literature. Thus, the purpose of this comprehensive literature review is to summarize findings and to discuss implications of empirical studies that have examined whether polygamous marital structures are beneficial or harmful to children in comparison with children raised in monogamous marital structures. This review includes a summary of the findings from all quantitative and qualitative studies in the extant literature that have examined the effect of polygamy on children's outcomes.

Reading comprehension among graduate students.

The present purpose was to examine graduate students' reading comprehension and reading vocabulary by comparing their scores on a standardized reading rest with scores obtained by a large normative sample of undergraduates. Participants were 59 graduate students from various disciplines, enrolled in three sections of an introductory educational research course at a southeastern university. These students were administered the Nelson-Denny Reading Test-Form G. Analysis showed these students had higher scores on the reading comprehension portion than did the normative sample of 5,000 undergraduate students from 38 institutions (Cohen d=.71). Also, the graduate students' scores on the reading vocabulary portion were higher (d=.45).