Female genital schistosomiasis (FGS) is a chronic manifestation of schistosomiasis, a waterborne parasitic infection, and is estimated to impact 56 million women predominantly in Sub-Saharan Africa. Currently, there is scarce literature on FGS and related health-seeking behaviour (HSB) among at-risk women. The objective of this mixed-method study is to understand the socio-cultural determinants of HSB and the health information trust networks for women at-risk of FGS in Ghana. A cross-sectional survey and twelve focus group discussions (FGDs) were conducted in the North Tongu and Weija Districts of Ghana. A total of 863 cross-sectional surveys and 12 FGDs were administered in both districts. There was an overall lack of awareness of FGS among adult women (38.9%). Only 48.8% of women reported HSB from the 86 women who choose to talk about their FGS-related symptoms. HSB was significantly associated with monthly steady income (p-value: 0.036) and level of education (p-value: 0.15,0.27), when controlling for age group and source of trusted health information. Some of the determining themes for HSB included: environmental and systemic context, shared norms, and apprehensions. Active and passive health information-seeking behaviour also emerged through the FGDs. Taking a mixed-method approach allowed for the appraisal of both methodologies and provided validity to the results. The lack of awareness of FGS indicates the need for tailored health information campaigns in endemic communities. More research is required on the FGS diagnostic and treatment capabilities of health facilities to understand their impact on HSB of women. This investigation finds that social, environmental, and cultural determinants are involved in the HSB of women at-risk for FGS, in North Tongu and Weija.

This study focuses on the topic Reports of concern in preschool and aims to explore the collaboration and interaction between different professionals involved in the process of handling such reports. The study utilizes a mixed-methods approach, starting with a quantitative survey distributed to individuals working in three different preeschool institutions and through the researcher´s personal Facebook page. The survey provided insights and generated specific questions for the subsequent phase of the study, which involved interviews with the professionals from three distinct roles connected to the process of handling reports of concern in preeschool. The collected empirical data was analyzed using Tomas Brante´s professional theory and associated concepts, as well as drawing on foundational ideas and concepts from Talcott Parsons´structural-functionalistic perspective. The analysis sheds light on the collaborative dynamics betwen professionals, the nature of the reporting process, and the dilemmas that can arise for each profession involved in reporting concerns in preschool. Additionally, the study demonstrates that these dilemmas can vary based on factors such as professional experience, education, and personal opinions. Overall , this research provides valuable insigts into the intricacies of handling reports of concern in preschool and highlights the importance of interdisciplinary collaboration and understanding within this context. The findings contribute to a deeper understanding of the challanges faced by professionals during the reporting process and help inform future efforts to enhance the effectiveness and efficiency of handling concerns in preschool settings.

Over the past 2 decades, mindfulness-based interventions (MBI) in sport have grown from a niche application for performance excellence into a mainstream intervention for performance enhancement and well-being among athletes. The Mindfulness Meditation Training for Sport 2.0 intervention has contributed to the growth through its initial empirical support. Open trials and feasibility studies have shown encouraging results in several student-athlete populations. The purpose of this study was to evaluate the impact of a MBI in sport, MMTS 2.0, through the lens of a mixed methods quasi-experimental design examining specific psychometric correlates related with performance enhancement and well-being and a sport-specific outcome measure. The aim is to provide a more in-depth understanding of student-athletes’ experience completing Mindfulness Meditation for Sport 2.0 (MMTS) and demonstrate the opportunity for performance enhancement and holistic development through a MBI in sport. Participants were 60 student-athletes from two Division III collegiate men’s soccer teams who competed a sport-specific performance marker and seven psychometric measures at two time points (pre-intervention and post-intervention). One team (n=30) was selected as the experimental group who received the MMTS 2.0 intervention, and another team (n=30) was selected as the control group (no-treatment). In contrast to the hypothesis, the experimental group showed no significant difference in the performance marker and the seven psychometric measures when compared to the control group. Though, exploratory additions showed significant improvement for the MTMS 2.0 experimental group in self-compassion from pre-intervention to post-intervention, while no change was found with the control group. The study offers promising results that indicate the MMTS 2.0 increase student-athletes scores of self-compassion. While the statistical findings are limited, the qualitative responses from the participants (n=9) suggest that the MMTS 2.0 had a strong impact on their performance as a student and athlete. These findings provide insight into how the delivery of mindfulness and self-compassion skills in a time-limited environment help male athletes combat competition distress. Recommendations for new mindfulness and self-compassion scales to capture impact of a time-limited intervention are offered.

Mothers are especially vulnerable to the onset or recurrence of psychological symptoms during the postpartum period. However, protective psychosocial factors may provide a stress buffering effect and promote a positive adjustment trajectory. In this series of studies, qualitative, mixed, and psychometric development methods were utilized to examine the nature, process, and measurement of perceived social support among mothers disproportionately parenting in the context of low economic opportunity. Study 1 utilized narrative interviews to explore themes related to maternal adjustment. Thematic analysis uncovered three key developmental processes: 1) “Stretching Identity; Transitioning Roles”, 2) “Navigating Stressors; Approaching Self-Efficacy”, and 3) “Changing Relationships; Strengthening Support.” Negative maternal self-attributions emerged as a key target for supportive intervention. Study 2 utilized a mixed methods triangulation design to obtain complementary qualitative and quantitative data related to perceived maternal social support, and between-group comparisons according to economic opportunity were conducted. Notable patterns emerged; namely, mismatches between the type of functional support elicited (e.g., emotional support) and a supportive individual’s response style (e.g. problem solving), resulted in conflict and maternal distress. In addition, perceptions of the support provided by healthcare providers differed based on economic opportunity, with participants from the higher economic opportunity group perceiving interactions as emotionally and instrumentally supportive, and participants from the lower economic opportunity group perceiving interactions as instrumentally supportive only. Study 3 contributed to the psychometric development of a novel, brief, and visually legible measure of perceived maternal social support originally developed for use in neonatal intensive care unit settings. Among mothers delivering at term, the measure demonstrated acceptable internal reliability, and a weak yet significant association with an established measure of perceived social support. Though trending in the expected directions, the measure demonstrated weak, nonsignificant discriminant validity when compared via correlational analyses with established mental health measures. The measure demonstrated stability across ranges of economic opportunity and cognitive ability. These studies address gaps in understanding of the nature, process, and measurement of perceived maternal social support during the postpartum period. Collective findings highlight targets for supportive intervention to facilitate postpartum adjustment, and implications for research and practice.

In psychometrics, a concern is that the assessment is fair for all students who take it. The fairness of an assessment can be evaluated in several ways, including the examination of differential item functioning (DIF). An item exhibits DIF if a subgroup has a lower probability of answering an item correctly than another subgroup after matching on academic achievement. Subgroups include race, spoken language, disability status, or sex. Under item response theory (IRT), a single score is given to each student since IRT assumes that an assessment is only measuring one construct. However, under cognitive diagnostic modeling (CDM), an assessment measures multiple specific constructs and classifies students as having mastered the construct or not. There are several methods to detect DIF under both types of models, but most methods cannot conduct explanatory modeling. Explanatory modeling consists of predicting item responses and latent traits using relevant observed or latent covariates. If an item exhibits DIF which disadvantages a subgroup, covariates can be modeled to explain the DIF and indicate either true or spurious differences. If an item exhibited statistically significant DIF which became nonsignificant after modeling explanatory variables, then the DIF would be explained and considered spurious. If the DIF remained significant after modeling explanatory variables, then there was stronger evidence that DIF was present and not spurious. When an item exhibits DIF, the validity of the inferences from the assessment is threatened and group comparisons become inappropriate. This study evaluated the presence of DIF on the Trends in International Math and Science Study (TIMSS) between students who speak English as a first language (EFL) and students who do not speak English as a first language (multilingual learners [ML]) in the USA. The 8th grade science data was analyzed from the year 2011 since science achievement remains understudied, the 8th grade is a critical turning point for K-12 students, and because 2011 was the most recent year that item content is available from this assessment. The item response theory with covariates (IRT-C) model was used as the explanatory IRT model, while the reparameterized deterministic-input, noisy "and" gate (RDINA) model was used as the explanatory CDM (E-CDM). All released items were analyzed for DIF by both models with language status as the key grouping variable. Items that exhibited significant DIF were further analyzed by including relevant covariates. Then, if items still exhibited DIF, their content was evaluated to determine why a group was disadvantaged. Several items exhibited significant DIF under both the IRT-C and E-CDM. Most disadvantaged ML students. Under the IRT-C, two items that exhibited DIF were explained by quantitative covariates. Two items that did not exhibit significant nonuniform DIF became significant after explanation. Whether or not a student repeated elementary school was the strongest explanatory covariate, while confidence in science explained the most items. Under the E-CDM, five items initially exhibited significant uniform DIF with one also exhibiting nonuniform DIF. After scale purification, two items exhibited significant uniform DIF, and one exhibited marginally significant DIF. After explanatory modeling, no items exhibited significant uniform DIF, and only one item exhibited marginally significant nonuniform DIF. Examining covariates, home educational resources explained the most with ten items and the strongest positive covariate. Repeated elementary school had the strongest absolute effect. Examining the item content of 14 items, most items had no causal explanation for the presence of DIF. In four items, a causal mechanism was identified and concluded to exhibit item bias. An item's cognitive domain had a relationship with DIF items, with 79% of items under the Knowing domain. Based on these results, DIF that disadvantaged ML students was present among several items on this science assessment. Both the IRT-C and E-CDM identified several items exhibiting DIF, quantitative covariates explained several items exhibiting DIF, and item bias was discovered in several items. Following up on this empirical study, a simulation study was performed to evaluate DIF detection power and Type I error rates of the Wald test and likelihood ratio (LR) test, and parameter recovery when ignoring subgroups, using the compensatory reparameterized unified model (C-RUM). Factors included sample size, DIF magnitude, DIF type, Q-matrix complexity, their interaction effects, and p-value adjustment. Evaluating DIF under the C-RUM, the DIF detection method had the largest effect on Type I error rates, with the Wald test recovering the nominal p-value much better than the LR test. In terms of power, DIF magnitude was the most important factor, followed by Q-matrix complexity. As DIF magnitude increased and Q-matrix complexity decreased, power rates increased. In terms of parameter recovery, the DIF type had the strongest effect, followed by Q-matrix complexity. Nonuniform DIF recovered the parameter more than uniform DIF, while fewer attributes measured by an item improved parameter recovery. Several factors affected DIF detection power and Type I error, including DIF detection method, DIF magnitude, and Q-matrix complexity. For parameter recovery, DIF type had an impact, along with Q-matrix complexity, and DIF magnitude. / Doctor of Philosophy / Academic assessments are a necessary tool to evaluate student educational progress in different subjects across school years. These are necessary to establish student proficiency within schools, districts, states, and countries. The results can be broken down to make various comparisons, including by race, ethnicity, gender, language status, schools, or any other demographic. Other comparisons can be made against a proficiency standard or passing rate. It is important and necessary to make comparisons between groups so that any disparities or achievement gaps can be identified and rectified. This study evaluated achievement gaps between multilingual learner (ML) students and English first language (EFL) students on individual items of an 8th-grade international science assessment. This subject and grade level are crucial for students preparing for college and starting their career development. Every test item was analyzed to determine if there was an achievement gap and if an item was biased against a group based on their first language. Several follow-up analyses were conducted on every item to ensure that the results were as accurate as possible and that there were no other plausible explanations. Several explanatory factors were evaluated, including student home educational resources, confidence in science, likes learning science, repeating elementary school, being bullied at school, and time spent on science homework. For items that had achievement gaps based on language, further analysis was conducted to ensure that the gaps were not due to other student characteristics. Based on that analysis, the item content was examined by myself and a content expert. This was done to evaluate if there were characteristics of the item that led to the language achievement gap. This allowed for the evaluation of whether an item was biased against either ML or EFL students. Fourteen items exhibited achievement gaps based on language status. Most items disadvantaged ML students, and the achievement gaps ranged from small to large. This initial analysis was followed up with more extensive analyses to rule out other potential causes of the achievement gaps. Repeated elementary school had the strongest relationship with these items, while confidence in science was related to the most items exhibiting achievement gaps. There were two items in which the language achievement gap was explained by a combination of factors, thus concluding that there was not any gap on the items. The remaining items still exhibited achievement gaps which led to analysis of the item content. On four items, the causes of the remaining achievement gaps were discovered. For the remaining items, there was no clear reason for the item bias and achievement gaps. This study was followed by a study to evaluate a new method of detecting achievement gaps. This was done by creating specific data so that the true values were known. The sample size, test item complexity, achievement gap size and direction, and gap detection method were evaluated. These conditions and their values were chosen to reflect realistic testing scenarios and provide a better understanding of the previous study's results. The results indicated that one achievement gap detection method had higher detection rates compared to the other detection method. This was true in all conditions. Additionally, achievement gaps were found more often when sample sizes and achievement gaps were larger, test items were less complex, and when one group was disadvantaged across all ability levels. When comparing the estimated and true statistics, there were large deviations when one group was disadvantaged at different proficiency levels. Also, when items were more complex, and sample sizes were smaller, the deviation between true and estimated statistics was larger than when items were simpler and sample sizes were larger.

The purpose of this case study was to answer 5 primary questions in order to determine the impact (efficacy, efficiency, and value) of the educational intervention known as the mental skills training program (MSTP) as implemented with an NCAA Division I volleyball team. The primary evaluation questions are (1) Was individual and/or team performance enhanced during the season? (2) How did the intervention of the MSTP impact individual and team mental toughness? (3) How did the intervention of the MSTP impact team communication and team chemistry? (4) How did the coaches and student-athletes view the investment of time and effort (value/worth)? (5) Was the program delivered effectively and efficiently? The core mental skills that comprise the MSTP are goal setting, visualization, feelazation, energy management, and effective thinking which when integrated encourage mental toughness. The program evaluation contains an instructional design (ID) that incorporated a flexible curriculum to meet the weekly needs of the team. A modified Gerlach and Ely (1980) ID model is utilized to direct the design process and also as a prescriptive evaluation guide. The evaluation utilized quantitative instruments including surveys, questionnaires, and assessments of the effectiveness and efficiency of delivery by the mental skills trainer. Qualitative data includes interviews and field notes consisting of observations, member checks, and peer debriefing. The results of the data indicate individual performance and mental toughness were enhanced; team performance and mental toughness may have been improved. Team chemistry was enhanced while team communication was not. The program was considered valuable and worthwhile and was delivered effectively and efficiently. The decision components of the program yielded an 84.69% positive program evaluation rating. In discussion of these results, team communication may be improved with a greater emphasis on teambuilding early in the program. Gains in mental toughness exceeded expectations, and a foothold has been established for future research in this area. Regarding team performance, expanding categories in survey instruments may yield a more positive evaluation. Finally, program evaluation may provide a viable research vehicle for applied sport psychology to demonstrate the efficacy of mental skills training for performance enhancement. / Ph. D.

Digital hostility has become an issue on social media, while discussing mentalhealth has become more recognized. Previous research has shown that influencersmost likely are not viewed as the ideal victim, thus leading to harassment becominga normalized and accepted behavior directed at them. The aim of this study is,therefore, to find out how the media audiences interact with influencers who openlyhave addressed their mental health issues online. In order to study the interaction, amixed method content analysis has been made on the comment sections of theinfluencers Gabbie Hannas and FouseyTubes TikTok accounts, as well as on thevideo responses made by the audiences. Parasocial interactions- as well as uses andgratifications-theory, were applied to this study due to their relevance to the subjectof interactions between the active audience and media content, or in this case, socialmedia influencers. Study 1, the quantitative content analysis, concluded that amajority of the comments were positive and supportive of Gabbie Hanna, while thecomment section under FouseyTubes videos often consisted of negative comments.The result for this part of the study aligned partly with previous research, whichstated that influencers often are victims of harassment and stalking-like behaviorsfrom the audience. Moreover it concluded that previous research regardinganonymous accounts being more likely to be hostile towards influencers, werecorrect. Study 2, the qualitative content analysis, concluded that a majority ofTikTok users use a negative tonality when making video-responses towards GabbieHanna and FouseyTube. Furthermore, the results aligned with previous researchwhich claimed society justifies digital hostility towards influencers. The observationshowed how the audience, generally, paid low- or no- regard towards the subject oftheir mental health. In conclusion, this study presents how the interaction betweentwo influencers, who have encountered a public scandal in regards to their mentalhealth, and TikTok users can look like. While the study may not be applicable toevery influencer, understanding of how the interaction can, and has, manifested isshown. In addition the study provides more context to how the culture online looksin regards to Gabbie Hanna and FouseyTube.

Background: Women have experienced increased mortality from coronary heart disease over the last two decades, while men‘s rate has declined. This suggests that current treatment and prevention strategies are less effective for women. Furthermore, since most women don‘t participate in cardiac rehabilitation, alternatives to these programs must be explored. Purpose: This study sought to refine an intervention for rural women with coronary heart disease designed to promote self-management and provide pilot data evaluating the efficacy of the intervention. Design and Methods: The study design was mixed methods. Focused qualitative interviews provided data regarding the self-management program. In-depth interviews determined the efficacy of the intervention including adoption of health promoting behaviors, self-awareness, and self-efficacy. The Self-efficacy for Managing Chronic Disease 6-Item Scale provided additional efficacy data and was administered over the course of the study. Ten women from rural New England, diagnosed with coronary heart disease within the last year, comprised the purposeful sample. Findings: The self-learning program met the women‘s needs; however they provided suggestions for improvement. While the women reported varying degrees of self-awareness, many believed the self-learning program influenced their adoption of health-promoting behaviors. In the interviews, the women expressed confidence in their ability to manage their disease; a finding that was congruent with the findings of the self-efficacy scale. Improvement was seen in five of six items on the self-efficacy scale from pre- to post intervention. The women‘s confidence in managing other symptoms or health problems and management of problems related to heart disease saw a statistically (p > .05) significant increase post intervention, and that increase persisted. One item, emotional distress, was flat over the series of administrations. Conclusions: Since women differ from men in the development, expression, and treatment outcomes for coronary heart disease, educational programs that address those differences and meet their needs must be developed. This study demonstrated that a paper-based, holistic, self-management program is a viable alternative or supplement to traditional cardiac rehabilitation programs. Using the self-and family management framework, this intervention enabled women to learn how to care for themselves.

Lexical inferencing is considered a listening strategy that is commonly employed by advanced EFL (English as a Foreign Language) listeners and a factor that contributes to successful listening comprehension. However, investigations of the factors that influence inferencing success in listening as well as how much each factor contributes to success are scant, as more studies have been conducted exploring lexical inferencing in reading. In addition, even though idiomatic expressions such as smell a rat, jump the gun, and go cold turkey are ubiquitous in the English language, especially in oral communication, and they are considered crucial in both first language (L1) and second language (L2) acquisition, little is known about the effectiveness of inferencing strategies where idiomatic expressions are concerned.Three goals motivated the current study. The first goal was to investigate whether inferencing is an effective strategy in the case where the target item is an idiomatic expression. The second goal was to investigate how four person-level factors, familiarity, listening proficiency, listening vocabulary size and working memory, two sentence-level factors, lexical density and sentence length, and two lexical-level factors, L1–L2 congruency and semantic transparency, influence the inferencing success of English idiomatic expressions in listening. The third goal, related to the second goal, was to determine which of the two lexical component factors, L1–L2 congruency and semantic transparency, is more important to inferencing success. A mixed methods design, the explanatory sequential design (Creswell & Plano Clark, 2018), was employed in this study. Quantitative data were collected from 89 EFL Japanese university students using a Listening Vocabulary Levels Test, a Listening Span Test, and an Idiom Inferencing Elicitation Task. The collected data were examined using mixed-effects logistic regression. Twelve participants were invited to participate in follow-up interviews based on their response patterns on the Idiom Inferencing Elicitation Task. The quantitative results indicated that familiarity, listening comprehension skills, working memory, and L1–L2 congruency were significant factors influencing inferencing success and the qualitative results supported these findings. In addition, the qualitative analyses suggested that depth of vocabulary is another potentially important factor. Furthermore, listening comprehension moderated the L1–L2 congruency effect. The finding that semantic transparency is not an influential factor in successful inferencing of unfamiliar idiomatic expressions provides evidence that the semantic transparency of known idiomatic expressions formed after learners acquire the meaning of the expression is a different construct from the perceived semantic transparency of unfamiliar idiomatic expressions. In addition, even though the sentence-level factors were not statistically significant in successful idiom inferencing in this study, further studies are required in order to see if this result holds true when the characteristics of the listening tasks differ from those of the task used in this study. It is hoped that the findings provide insights into how to help Japanese university EFL learners improve their listening skills, especially in tasks that include unfamiliar idiomatic expressions. / Teaching & Learning

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