The world of work is being changed at an unprecedented rate as a result of the rise of the Fourth Industrial Revolution. This rate of change was accelerated by the COVID-19 pandemic, which left organizations and their leadership to deal with myriad of challenges. These changes also impacted leaders’ identities in their work and their roles in their organizations. We examine how leaders responded to the various workplace challenges presented by the COVID-19 pandemic and what this meant for their work identities as leaders. To do this, we made use of role identity theory, social identity theory, and leader identity. A qualitative study was conducted with a group of eight senior leaders from various South African and global organizations who had between five and 10 years’ work experience, and some had even more. Data were collected through semi-structured interviews, conducted virtually and in person. Thematic analysis was used to analyze the data. The main finding that emerged from the research was that leaders employed virtual leadership to ensure that customers’ expectations were met, and to manage team-and organizational performance. These leaders achieved this by fostering a digital culture and building effective teams. They achieved their leadership goals by ensuring social identity continuity amongst their teams. This required them taking on extra roles, such as strategist, technology expert, entrepreneur, coach, mentor, and member of the team. Their leader role identity, as part of their work identity, was amplified by the pandemic. The implication is that organizations should develop leadership development programs to increase and strengthen leader identities to capacitate them for times of crisis. The COVID-19 pandemic ushered in unprecedented change for organizations globally. Leaders had to design fit-for-purpose operating models, which included new ways of doing things, new roles, and new ways of leading self and others .COVID-19 was first identified in November 2019, in Wuhan, the capital of China’s Hubei province. The disease causes severe acute respiratory illness, which was sometimes fatal. The disease rapidly spread around the world, and no continent escaped the disastrous health consequences and socio-economic impacts.Leaders worldwide were forced to design and implement strategies to deal with the pandemic at a very fast pace. National lockdowns were instituted globally, which compelled people to remain in their homes, in an attempt to control the spread of the virus. In South Africa, the economy slowed down, job losses increased, and other existing socio-economic challenges were exacerbated as a result of the lockdown regulations. During the lockdown period, the tools and technology of the Fourth Industrial Revolution (4IR) were implemented at an accelerated rate  to estabLittle is known about how a crisis like the COVID-19 pandemic affects the way leaders leads and the influence this has on their identities as leaders. There is a clear link between identity and leadership , which iWork identity can be considered a “multi-identity, multifaceted and multi-layered construction of the self” , p. 4. GWork identity is formed through the personal experiences, occupational skills, work context, work practices, and social memberships of an individual. It is considered “the importance of work for a person’s sense of self” , p. 1 anSocial identity theory describes how selves are personally, contextually, and socially derived . An indiOrganizations are social entities comprised of groups of people who collaborate and interact to perform work, and these groups of individuals develop and sustain socially derived identities . The ideRole identity theory seeks to explain the various roles we hold in our lives, and that “these roles come with prescriptions of how individuals should behave” , p. 2. AIf individuals have a strong role identity, they are more likely to take part in the role-based behaviors associated with the role, thus meeting role expectations . AccordiHow a leader’s identity is formed at work may also be explained through role theory . Kwok etLeader identity is defined as “a sub-component of one’s identity that relates to being a leader or how one thinks of oneself as a leader” , p. 365.A qualitative approach was used in this study, as we sought to understand the perceptions and related actions of leaders in the COVID-19 pandemic. Purposive convenience sampling, augmented by snowball sampling, was used, as it enables researchers to select participants who will make a valuable contribution to understanding the problem under study , p. 239.Otter.ai.The data were collected using semi-structured interviews. This method was utilized because it offers flexibility by allowing new topics to emerge for exploration and further discussion . AdditioParticipation was voluntary, and each participant signed an informed consent form. Anonymity and confidentiality were maintained throughout the research. Prior to the commencement of data collection, ethical clearance (#IPPM-2020-465M) was obtained the Ethics Committee of the Department Of Industrial Psychology and People Management at the University of Johannesburg.The sample for this study consisted of a group of eight leaders from various South African and international organizations who led projects, business units, and/or teams during the COVID-19 pandemic. The data were analyzed using thematic analysis, which is “a method for identifying, analyzing and reporting patterns (themes) within data,” and is widely used in qualitative research , p. 79. Overall, participants related that the pandemic regulations introduced issues such as endless online meetings, burnout because of longer working hours, impacts on family life, negative effects on physical and mental health, increased customer needs, and supporting teams with issues such as fear of job loss, illness, and death in the family, working from home with limited office space, and stress. Many participants indicated that it was both challenging and enriching to lead themselves and their teams during this time. It is clear that the leaders occupied multiple roles during the COVID-19 pandemic in order to keep up with the change.The detailed findings of this study are presented according to five themes, namely (a) Customer centricity, (b) Managing performance, (c) Building effective teams, (d) Building a digital culture, and (e) Work identity.Customer centricity theme emerged mainly when the participants were asked what they liked most about their role. The leaders in this study mentioned that it was key to understand customer needs so that they could build products and services that would satisfy their customers’ needs and expectations. The codes that emerged under the customer centricity theme were: (a) understanding the business, (b) understanding customer needs, (c) building solutions for customers, (d) judgment and risk-taking, and (e) building great relationships with customers.The For example, with regard to understanding the business, participants noted a renewed focus on certain aspects. Participant 1 said: “I like the outcomes of this role. Being able to retain the client, understanding the outcomes of the customer research, relooking product information and pricing in order to retain clients, and achieving customer retention targets for a large insurance company is satisfying.” Statements to support this included “I have to meet my customers delivery dates” (Participant 3) and “We used basic technology to help with research to understand why our customers were leaving us” (Participant 1).Many participants indicated the need for building solutions for customers, for example: “In an ever-changing environment, the organization looks to its leaders to provide the solutions during times of change. I must provide strategies and solutions” (Participant 4).With regard to judgment and risk-taking, some leaders indicated that, in a highly regulated environment such as banking or insurance, there is little room for judgment and decision-making, and that this can be frustrating when it slows down delivery and meeting customer expectations. Participants indicated that they preferred a work environment where they are empowered to use their judgment in making decisions in a collaborative way, provided they do not place the business at risk. In support of this, Participant 1 stated: “I would make a judgment call and go outside the boundaries, as long as it was legal and not putting the business at risk …. There has to be room for strategic thinking, planning, and flexibility to allow for non-conventional decision-making, and I must be able to use judgment in decision making.” Participant 8 stated: “I like an environment where people are empowered and expectations are clear.”Concerning building great relationships with customers, participants indicated that key to business success is the ability to remotely build relationships with customers and partners. Participant 6 proudly noted: “I am a trusted business partner,” while Participant 5 said: “I build great relationships with my client base.” However, some participants indicated that building customer trust was very challenging during lockdown.organizational strategy, (b) setting clear goals and expectations, (c) providing open and honest feedback, (d) coaching, (e) acknowledging one’s team, (f) building relationships with the team, and (g) trust.Leaders in this study mentioned they had to assume the role of performance manager for their organization, their team, and for themselves. In addition to this, they had to also see to the wellbeing of their individual team members. According to Participant 8, “COVID has affected people’s mental health. It has affected their ability to engage externally, it has affected their ability to even engage in the company. So, now you must pay much more attention to mental health and wellbeing instead of staff performance only.” Participants stated that, during the COVID-19 lockdown, they were “dealing with staff wellbeing…, especially mental wellbeing” (Participant 5), and “loss of loved ones, general fear, and manual processes” (Participant 8). This led to participants adjusting the way in which they managed staff performance and led during this period. This theme is supported by the codes (a) With regard to organizational strategy, participants indicated that they had to get involved in formulating strategy in a collaborative way with internal and external partners. This is evidenced by the following extracts: “I spend an awfully long time coaching rather than leading. I play different roles—strategy, coaching, implementation, alignment. My brain had to change six or seven times a day, depending on what kind of call I have” (Participant 6).Leaders indicated that setting clear goals and expectations was key in managing their own performance and that of their team, and that this aspect became crucial during lockdown, when teams had to work virtually. Participant 2 noted having to get “something sorted out” to meet targets. Participant 1 mentioned a focus on “outcomes of the role, being able to retain the client, achieving the targets.”The participants indicated that, in building an effective team, providing open and honest feedback to their peers, their managers, and the people who report to them is crucial in achieving desired outcomes that would ultimately address customer needs and ensure achievement of performance objectives. This was made clear through statements such as “I must have a positive attitude, let go and move on, be open and honest, have no hidden agenda, and provide honest feedback” (Participant 3), “I will confront issues that I believe needs to be changed for the good. I will speak my mind” (Participant 2), and “Coaching becomes very key in giving real-time feedback” (Participant 7).The code coaching was mentioned several times by participants during the discussion of team performance. This code was mentioned by two participants as the element they enjoyed the most in their job. Participant 7 had taken on “coaching people to be their best in their current role,” while Participant 6 stated, “I spend an awfully long time coaching rather than leading.” Participant 2 said that she had enjoyed the “opportunity to display natural leadership, interacting with people, giving guidance to others, setting the example, coaching, and mentoring.” Participant 8 indicated: “I have check-ins with the team once a week, sometimes impromptu meetings, not about work, but about their lives. I create a platform for people to discuss their issues—mental health, dealing with loss of family due to COVID-19, fear of losing jobs, combining home life and work life while working from home, etcetera” (Participant 8).The participants all mentioned the importance of acknowledging one’s teams, and most of the participants spoke at length about the importance of having a high-performing team and the leader’s role in building such teams. Participants indicated that their ideal work environment was one where everyone understood what they must do, and that they do it. Participant 4 stated, “What I like most in my role is team involvement and teamwork,” and added: “I view myself as one of the guys, as a team member. I don’t enforce my position.” Participant 2 stated: “What I like most in my role is the opportunity to display natural leadership, i.e., being a leader without necessarily having a leadership title, interacting with people, giving guidance to my team, setting the example, coaching, and mentoring.”When participants were asked what they enjoyed least about their role, the trust code emerged. Leaders all indicated in some way that building trust was vital. Participant 3 indicated that she trusted her team, but that this became challenging when employees worked virtually. This meant working harder to build trust: “I do trust them, but I know the staff well-enough to know that they’re not going to do the work when you need them to do it. So, I’ve got to double check, unfortunately.” Participant 6 noted: “I think the biggest challenge is where you have relationships, where you have established, mature trusted relationships before COVID. Those relationships continue, and you can continue to build on them virtually. But, where you do not have relationships, it’s almost impossible to build new ones, and that is the impact of COVID.”effective leadership, (b) changed leadership style, (c) resilience, (d) making decisions, and (e) upskilling teams.Building effective teams is a theme supported the following codes: (a) With regard to effective leadership, Participant 3 described the challenges of managing a team in this time, stating: “There are many moving pieces in the shipping logistics world. This aspect became even more challenging during COVID-19. It is very stressful.” Participants indicated that certain leadership attributes have become more important than ever. “I lead from the front, and I am an entrepreneurial leader. I have received award for being an innovative leader and doing things differently during COVID,” said Participant 5. Participant 8 stated that she was “an inspiration to my team. I expect a lot, I am very self-aware,” while Participant 1 described herself as “committed, dedicated and passionate.” Participant 2 stated, “I want to influence horizontally, I am assertive, I express myself.” Participant 3 mentioned, “I lead by example; I make sure I am available for my team, and I jump in and work with them.” Participant 5 indicated: “I led from the front during this crisis, I met all my people online, managed the team electronically, got in the same room at the same time, built new portals… Find new ways of doing things—new financial checks, deal with uncertainty, deal with sickness, losing loved ones etcetera, this is leadership on another level.”The code changed leadership style emerged from participants’ discussions about how they dealt with the new challenges. They indicated that they had had to change the way they led, and that they had to learn new ways of doing things. For example, Participant 7 commented: “Managers are having to deal with the wellness component. “Is the person that I’m dealing with, okay?” “Are they feeling alone?” “Are they heading for burnout?” “Are they stressed?” As a leader, that’s another element that you have to manage” (Participant 7). A number of participants supported the sentiment of Participant 3, who noted: “Before COVID, I was not a hovering manager, because I was with the team. Now, I have to check in all the time to see if work has been done. I don’t like doing it, but I have to make sure it is being done.” Participant 6 mentioned the positive aspect of now “having a better understanding what the impact of COVID is on your business. We know for example, how many people [staff members] are sick—we get a weekly update. Participant 5 advised: “Lead with humanity.” Participant 3 noted that “being able to manage people remotely requires a mindset change to manage people where you don’t see them.” Other participants expressed similar changes in mindset: “I have to define boundaries; for example, I said to my team, “No meetings, after a certain time.” I am flexible with my team; it’s a give-and-take mindset. Different people’s work styles require different approaches. Some people need to be micro-managed: “Now you have to sit down” … schedule teams meetings, talk to them about the fact that they have to be self-reliant. We don’t have time to micro-manage people. Also, you’re getting involved in their personal lives … must approach people more holistically… more empathetic. More understanding is required, not only a manager of work, but of context and socio-economic conditions” (Participant 8).Participants noted that resilience, both their own and their team’s, was vital in coping with the new uncertainties and fears. Participant 5 noted: “It has taught me that human beings are wired up to just cope regardless of the odds. The best leaders led their teams to find ways to cope during this time.” Participant 5 noted the importance of developing resistance, both your own and that of others.With regard to making decisions, most participants indicated that, to effectively lead self, others, and the organization, they had to make decisions quickly. However, some participants indicated their frustration with being in a highly regulated environment (such as banking and insurance), where quick decision-making is vital in order to attract and retain customers.Many participants noted the importance of upskilling teams to effectively deal with the challenges brought about by the pandemic. Participant 2 explained: “We experienced challenges mostly in the beginning of COVID-19, where staff did not have access to online tools. We had to ensure tools are available and staff are proficient in using the tools.” Participant 5 stated: “I think leaders must be honest about their lack of skills and ask for help,” while Participant 7’s strategy was to “learn on the go.”emerging technology, (b) new ways of working, (c) work–life balance, (d) ideal work environment, and (e) a new way of leading.The crisis brought about by the pandemic forced these leaders to fulfill their roles through a digital culture. The theme is supported by the following codes: (a) With regard to emerging technology, some of the leaders indicated that only through emerging technology could they perform their work during the lockdown. They indicated that it was a steep learning curve, but one that was well-worth it. “Technology is the only reason I can work,” admitted Participant 6. She continued, “I have a laptop, I have unlimited data, and the company is migrating us from our current phones to iPhone 12 … She noted that she was able to migrate to the new phone “with zero support from IT,” adding, “Everything that is transactional can now be done in a digital way.” Participant 1 also noted the ease of technology: “Technology has made my work easier; many processes were smoother and faster. It allowed me to learn new skills and multi-task.” Participant 5 noted the need for technology “to make people-related decisions to enhance organizational performance, and added: “I have had to reflect on my ability to utilize technology. I have had to upskill myself.”New ways of working came up frequently, with leaders noting that emerging technology and COVID-19 ushered in new ways of working, where virtual working in a flexible way became the norm, requiring continuous learning, adaptability, collaboration, and a change in mindset. Participant 5 remarked: “I’m not a big techie…, but I have to learn to do things differently. Everything is fully automated and, in property, one now needs to understand how to fund green buildings. Drone technology is also used to see and inspect our properties … but, at the end of the day, one must walk the assets to get a real feel for the property. It has been a massive disruptor, and I am still figuring out if I really like it or not (Participant 5). Participant 2 also noted the impact of technology: “I had to learn new ways of doing things very fast, for example, Google Classroom. This also meant dealing differently with class discipline. I had to provide a blended approach to learning.” Participant 1 noted: “It allowed me to learn new skills better and multi-task. It also made my work easier. Many processes were smoother and faster.”Most leaders found that technology and working virtually positively impacted their work–life balance. “There is now technology to enhance what I am doing, and it afforded flexible working hours” (Participant 1). Participant 4 noted: “It has had an impact on work–life balance, since I spend more time with my family.”Leaders shared their views of an ideal work environment, with Participant 8 commenting: “I like an environment where people are empowered and expectation is clear” (Participant 8). “Red tape was diminished; processes were optimized” (Participant 2). Participant 6 suggested “30% in the office, 30% with external stakeholders, 30% in the field with your people, and then 10% thinking, reflecting, reading.” Participant 6 also expressed concern around the over-digitizing of the work environment, which leads to culture of anonymity.strategist/visionary, (b) entrepreneur, (c) high performer, (d) one of the team, (e) influential, and (f) self-aware.Participants had to adopt several roles during the COVID-19 pandemic, which affected their work identity. The theme is supported by the following codes: (a) The participants found that one of the new job roles that they were expected to participate in was that of strategist/visionary. Participant 6 mentioned: “I play different roles—strategy, coaching, implementation, alignment. My brain changes six or seven times a day, depending on what kind of call I have. Participant 4 also indicated that he has to get involved in developing the vision and strategy to produce new ideas for his organization, in collaboration with others: “In an ever-changing environment, the organization looks to its leaders to provide the solutions during times of change. I must provide strategies and solutions. What makes it easier is that we collaborate with our partners to assist with this task.”With regard to being an entrepreneur, the participants, particularly Participant 5, noted the importance of an entrepreneurial leader: “I innovate and have innovated during 4IR and COVID-19 pandemic—doing things differently.”Participants encouraged their teams to be high performers by role-modeling the behavior. As Participant 5 put it: “I lead from the front.” Participant 3 noted: “I lead by example. I make sure I am available for my team, and I jump in and work with them.”Participants indicated that they became one of the team to achieve objectives. Participant 4 explained: “I view myself as one of the guys, as a team member. I don’t enforce my position. I speak Afrikaans and English to accommodate the team members.”A number of participants indicated that an aspect of their work identity was being an influencer. “I influence horizontally, I am assertive, I express myself” (Participant 2). Participant 8 noted: “I am an inspiration to my team. I expect a lot. I am very self-aware.”The present study explored how leaders responded to the workplace challenges presented by the COVID-19 pandemic and what this meant for their work identities as leaders. To do this, we made use of role identity theory, social identity theory, and leader identity theory. The leaders in this study had mainly two broad responsibilities: first, to ensure that they performed in their roles as they did before the pandemic and delivered on objectives, and, second, maintained team cohesion and performance. This they had to achieve in the context of remote working and virtual leadership.Recent research indicates that many companies made use of virtual leadership to maintain their organizations during this period . LeadersAs part of overcoming challenges, the leaders fostered a digital culture to ensure that customer expectations were met and team performance was managed. Most welcomed technology and used it to enhance delivery of products and services. One participant referred to the threat of a culture in which people become “anonymous” as a result of over-digitizing procedures, and noted that this was not ideal when attempting to build effective teams. Some leaders focused on building and enhancing teamwork to compensate for the challenges that came with over-digitizing procedures.Technology changes the organizational context, which reshapes work identities. Technology artifacts become standards in “self-narratives” when the function thereof aligns with the work identity of an individual , p. 178.One of the main themes was building effective teams, which, according to one participant, entailed becoming “one of the team.” This required self-awareness. By becoming one of the team, the way a leader strengthens his/her position as a leader and as a professional is now informed by a different or additional team members. By leading the team and being one of the team, it is argued that the leaders helped to strengthen the social identity continuity for themselves and their employees. In a study on leaders and their employees during the COVID-19 pandemic, social identity continuity was found to be related to job satisfaction . As workWork identity is multidimensional, consisting of roles  or “selvThe participants shared that their leader role identity, as one of the multiple facets of their work identity, emerged stronger during the COVID-19 pandemic. Their aim was to ensure effective staff performance and, ultimately, organizational survival. This is aligned to the view of The leaders under study were also required to deal with matters related to employee wellness and work–life balance. As a result, many of the leaders took on the extra role of coach to guide their teams through personal struggles such as the loss of family members, the fear of losing their jobs, illness, and longer working hours. The pandemic had a tremendously negative effect on the wellbeing of employees , and theThe main finding that emerged from the research is that the leaders fostered virtual leadership to ensure that customer expectations are met, and to manage and enhance team-and organizational performance. They achieved their leadership goals by ensuring social identity continuity amongst their teams. To do this, they had to take on extra roles, such as strategist, technology expert, entrepreneur, coach, mentor, and member of their team. Based on these findings, we argue that leader identity, as part of a leaders work identity, is enhanced and lived out by leaders ensuring social identity continuity amongst their teams and fulfilling the respective leadership roles that come with their leader role identity. This study has linked role identity, leader identity, and social identity theory with work identity in examining the ways in which leaders lead and identify with their leadership role during a time of crisis.There are two methodological implications in this study, which could also be considered limitations of the study. The first one, being that most of the semi-structured interviews were conducted using online platforms, due to the COVID-19 pandemic restrictions. As a result of this, important social cues that are easier to pick up on in face-to-face interviews may have been missed. Secondly, six of the participants were female and only two were male, as a result of purposive convenience and snowball sampling may have created gender-bias implications.Organizations should focus on the development of leaders’ work identities in their leadership development programs and initiatives, coupled with taking into consideration the multiple complexities associated with leadership roles. Aspects such as role congruity need to receive greater focus for development programs, to create better leader–job fit, which ultimately would enhance leader-role identity and overall work identity. There should also be a focus on crisis management within the broader organizational context. The study revealed the importance of leadership playing a role in ensuring the wellbeing of their employees, and HR practitioners and leaders therefore need to prioritize organizational initiatives around wellbeing during times of crisis.As this was a qualitative study, the findings cannot be generalized to the greater population. This study consisted of a sample of eight leaders from different organizations.Future studies should be conducted on a larger sample with participants from multiple countries, in order to gain a broader understanding of identity formation of virtual leaders in times of crisis. Researchers should ensure a representative sample, which would yield insights according to gender and ethnicity. Future research could also be longitudinal, in order to gain an understanding of developments over time. Such research could include quantitative instruments to complement the data.via technology. In this process, leader role identity, as one dimension of the work identity, emerged more strongly, with the leaders viewing themselves as strategists, coaches, and team members. They had to learn to lead differently. As the new world of work continues, leaders need to strengthen their role identities as leaders, in other words, their leader self-concept, to lead effectively in times of change and crisis. In this way, leaders will be able to strengthen the social identity of their teams and followers.The leaders who participated in this study had a stressful task in leading and creating social identity continuity amongst their teams in order to lessen the effects of the COVID-19 pandemic. This was achieved by virtual leadership roslynd@uj.ac.zal.The datasets presented in this article are not readily available because the data has not been made publicly available due to the restrictions imposed as a result of privacy and ethics. Requests to access the datasets should be directed to RD, The studies involving human participants were reviewed and approved by Ethics Committee of the Department of Industrial Psychology and People Management, School of Management, College of Business and Economics, University of Johannesburg, ethical clearance number: IPPM-2020-465(M). The patients/participants provided their written informed consent to participate in this study.This article was adapted from the Master’s mini-dissertation of SM, who conducted the research. RD was the study leader, and provided conceptualization guidelines and editorial inputs. Both authors contributed to the article and approved the submitted version.


Vietnam’s post-war globalization, economic development, and urbanization have contributed to a nutrition transition from traditional diets to highly-processed diets, and increased prevalence of childhood overweight and obesity. Our study aims to explore the attitudes and behaviors driving this epidemic.This qualitative study focused on the perspectives and practices of Vietnamese parents, schoolteachers and doctors. Semi-structured interviews were conducted with a convenience sample of 12 regarding the historical, social, and cultural influences contributing to childhood overweight and obesity. Audio-recorded interviews were translated and transcribed, then analyzed using modified ground theory to identify themes and representative quotes.Five themes were identified: (1) Change in diet between generations, (2) Preference for rounder children, (3) Unhealthy feeding practices, (4) Reduced physical activity, and (5) Increasing awareness of childhood obesity. A conceptual map detailed the shift from war-time to post-war economic environment and psycho-social context for raising children to be large, safe and academically-successful.We found that globalization, urbanization and economic development—in the context of historical, social and cultural attitudes—may contribute to increasing child obesity in Vietnam. Obesity prevention through public health and educational institutions should involve policies and programs for healthy eating and exercise, tailored to address parental figures’ concerns. Rates of child obesity in Vietnam have increased dramatically over the past two decades. Previous existing qualitative assessments for this increased prevalence prevail, and our findings show how Vietnam’s post-war economic development, globalization and urbanization—in the context of deep-seated historical, social and cultural attitudes—may contribute to risk for child obesity and other non-communicable diseases. We identified the need to tailor policies and interventions to promote healthy diet and physical activity to support parents’ and grandparents’ fears and concerns.For many low- and middle-income countries (LMIC), childhood obesity is an emerging problem. Many countries exhibit the “double-burden of malnutrition”, in which childhood underweight and overweight both exist Poskitt, . Though th largest export market for food and beverages from the United States  and University of California San Francisco (#585-1) by the UC Reliance System. We have followed the COREQ criteria for reporting qualitative research throughout this research study  and mập (meaning “fat" or “chubby”) were used to justify this preference. Parents refrained from using the formal word for overweight/obese, béo phì, to refer to their children since the term is considered offensive. A health professional described how larger children reflect a higher socio-economic status and good parenting:There’s an inherent flaw in our culture. It’s an old way of thinking. We think round children are ideal. It’s a reflection of their wealth, their ability to support. The only way a child can be round is if you are rich.Parents described their preference for having “rounder” children who would be viewed as “healthy.” Endearing Vietnamese terms such as Kids start with eating and drinking sweet foods, then they grow up to like sweet foods.Economic prosperity, urbanization, food abundance, and a preference for rounder children, contributed to the trend of overfeeding children. On a daily basis, key informants reported that children ate more than 4 meals, drank sweetened milk up to 5–6 times, and consumed unhealthy snacks and beverages. On special occasions, families celebrated with fast food meals. One doctor summarized:…For folks here, when it is their children’s birthday, they are treated to fast food. They go all out.A teacher highlighted:If they live in the city, it takes only about a minute to reach these foods/drinks… If they live in a story complex, it takes a minute to go down the elevator and buy them. If they live in a [house], they just need to go... next door. If they’re outside, it takes about one to five minutes to walk to the nearest place that sells these foods/drinks.Particularly in urban areas, the widespread availability of enticing and low-cost processed snacks, sugary drinks, and fast foods made them a daily part of children’s diet at home and outside. One teacher commented:Back then... Our parents did not tend to us—we walked to school by ourselves… but now the villages and the cities are so crowded. There’s a common fear of kidnapping, so parents are stricter now. We take them to school. If we don’t have a car, we’ll take them on a scooter. There are few people who walk their kids to school.Many parents discussed physical environments leading to less opportunity for physical activity for children, both at-home and at-school. Whereas parents recalled walking or biking to school and playing outdoors, they are now afraid of their children growing up in an urbanized environment with dangers of traffic and child abduction. With motorcycles or cars, parents feel safer driving their children to school. One teacher recounted:There’s little push to exercise, to play sports. There’s a big push to study, to go to school. The kids don’t have time to play sports.Parents also described the increased focus on ensuring their children’s academic success. As a result, more time at school and at home is devoted to studying, rather than to sports and physical activity. One doctor described:When they don’t want to be active, they won’t. They often just like to sit, lay around, and be motionless. [My] oldest [child] likes to do this and watch TV.In addition to studying at home after school and on weekends, parents described allowing their children to have substantial screen time for entertainment. One teacher explained:On average, a lot of children by twelve months can walk. Now, they struggle with standing up because of how overweight they are. These children generally can only get up when they’re 16 to 17 months old.Among health and educational professionals, and parents with higher levels of education is an increasing awareness of the adverse consequences of child obesity on children’s health and development. One teacher noted:I don’t let [my child] drink many sugary drinks, but he does like to drink them. [He] will always ask for them, but [my husband and I] just don’t generally let him drink them. [We] prevent him from [having] sugary drinks. We let him drink water only.Many noted the need for the childhood obesity epidemic in Vietnam to be addressed on a parental-level, school-level, and government-level. One teacher described their efforts:[Schools are] more likely to have foods that the children like to eat, whereas at home, there may be foods not to the children’s liking.Although many parents described their attempts to limit sugar-sweetened foods and beverages at home, they noticed that their efforts were undermined by children’s increased access to these foods and beverages at and around school.There should be more exercise in school, but also in the home. I think this is an issue of great prevalence in Vietnam… This is especially true in wealthy families within the cities.Many parents also recognized that their children needed more physical activity at home and at school to further promote a healthy lifestyle. One teacher said:The government just issued a warning about the nutritional values to the public, but there is no policy or law being implemented that provides direction for people to follow.Parents recognized the role of the government in keeping their children healthy; with this increased access to and abundance of sugar-sweetened foods, one teacher explained where the government could help:Figure , unhealthy feeding practices, reduced physical activity, and increasing awareness of childhood obesity. Study participants described the roots for parents’ attitudes and practices in the historical, economic, psychosocial, and cultural influences of their war-time and post-war environments.This qualitative study of a convenience sample of Vietnamese parents, schoolteachers and doctors found five themes associated with child obesity—change in diet between generations, preference for rounder childrenOur study supports the findings of other global quantitative and qualitative studies identifying the contributors to child obesity—excessive feeding and insufficient physical activity—with factors at the child, family and community levels  and Da Nang , which may reduce the generalizability to families from northern cities, rural areas, lower socioeconomic strata, and ethnic minority populations. Therefore, our participants do not represent backgrounds of all socioeconomic strata and all regions of Vietnam, where our themes may vary or differ among different subgroups in Vietnam. Although the sample size of twelve appears small, the semi-structured interview format enabled deeper exploration of participants’ thoughts and feelings; and the use of multiple translators, transcribers and coders facilitated extensive discussion and analysis of themes. One study asserts that twelve interviews is sufficient to saturate themes—when no new subthemes or themes are observed in the data—and thus, our sample size could be considered appropriate , and safe physical activity environments . In addition, public education programs should reach out to families through maternal-child health services, preschools/schools and media with clear messages on child nutrition and physical activity for obesity prevention— with carefully-designed messages to support parents’ and caregivers’ motivations for healthier child-rearing practices—including encouraging traditional diets, avoiding overfeeding, limiting screen time, and encouraging active play.Our qualitative study of a convenience sample of Vietnamese parents and child health and development professionals found that globalization, urbanization and economic development—in the context of deep-seated historical, social and cultural attitudes—may contribute to increasing child obesity. To effectively reduce child obesity, public health and educational institutions should advance their efforts to promote policies and programs for healthy eating and physical activity, tailored to address and support parents’ and grandparents’ fears and concerns.


Extended foster care programs help prepare transitional-aged youth (TAY) to step into adulthood and live independent lives. Aspiranet, one of California’s largest social service organizations, used a social care management solution (SCMS) to meet TAY’s needs.We aimed to investigate the impact of an SCMS, IBM Watson Care Manager (WCM), in transforming foster program service delivery and improving TAY outcomes.We used a mixed methods study design by collecting primary data from stakeholders through semistructured interviews in 2021 and by pulling secondary data from annual reports, system use logs, and data repositories from 2014 to 2021. Thematic analysis based on grounded theory was used to analyze qualitative data using NVivo software. Descriptive analysis of aggregated outcome metrics in the quantitative data was performed and compared across 2 periods: pre-SCMS implementation  and post-SCMS implementation .In total, 6 Aspiranet employees (4 leaders and 2 life coaches) were interviewed, with a median time of 56 (IQR 53-67) minutes. The majority  were female, over 30 years of age  with a median of 6 (IQR 5-10) years of experience at Aspiranet and overall field experience of 10 (IQR 7-14) years. Most  participants rated their technological skills as expert. Thematic analysis of participants’ interview transcripts yielded 24 subthemes that were grouped into 6 superordinate themes: study context, the impact of the new tool, key strengths, commonly used features, expectations with WCM, and limitations and recommendations. The tool met users’ initial expectations of streamlining tasks and adopting essential functionalities. Median satisfaction scores around pre- and post-WCM workflow processes remained constant between 2 life coaches ; however, among leaders, post-WCM scores  were higher than pre-WCM scores . Across the 2 study phases, Aspiranet served 1641 TAY having consistent population demographics . Between the pre- and post-WCM period, there was an increase in full-time school enrollment  and a reduction in part-time school enrollment . The median number of days spent in the foster care program remained the same ; however, the number of incidents reported monthly per hundred youth showed a steady decline, even with an exponentially increasing number of enrolled youth and incidents.The SCMS for coordinating care and delivering tailored services to TAY streamlined Aspiranet’s workflows and processes and positively impacted youth outcomes. Further enhancements are needed to better align with user and youth needs. This leads to an open and more productive discussion between the youth and caregivers and helps to identify the youth’s specific needs  and to make targeted plans. Aspiranet plays an important role to help youth achieve the actual goal by linking resources to needs through collaboration with various agencies . To make“I was going to say, it’s just kind of my job is kind of like the tour guide. It’s like, I’m like that step. Yeah, like on their side so, like, as they’re kind of moving along, I’m literally there through every step.” [Life coach]All interviewees mentioned the prevailing diversity in youth population demographics in terms of gender, age (18-24 years), race and ethnicity, and religious backgrounds. All patients experienced some type of trauma in their lives. They all pointed out an array of pressing challenges that their clients face , often m“I would say housing just because the market for this particular population is scrutinized sometimes only because they’re young, so when it comes down to being 21, a lot of apartment complexes don’t necessarily like to work with 21 year old. Landlords think our clients are not mature enough to handle the pressure of being on their own. So, it’s a lot of the housing & on top of them having the housing crisis that we’ve had for a few years.” [Leader]Several challenges were brought up by leaders and life coaches and grouped into 2 main categories: one independent of the COVID-19 pandemic and the other ensuing or surfacing during the COVID-19 pandemic. Agencies working in silos owing to lack of integration and coordination are another important challenge. The continuing reliance on paper and not being fully digitalized added more challenges to the processes. Some challenges noted include having large amounts of data from different data resources; data existing in various formats and in different locations; duplicate data entry; and not being able to comprehend the full picture of the youth’s records from multiple discrete pieces of data. Financial challenges and limited funding, especially to meet housing needs in the state of California with the rising cost of living, were mentioned most often. Among other challenges that are directly or indirectly affected by the COVID-19 pandemic are those related to hiring staff, developing and training new employees, and excessive workloads. Lack of integration and coordination“You know, the lack of integration or coordination. With other departments & agencies, we often work in silos where other providers are out there, providing the same type of work that we’re providing & kind of doing it in silos.” [Leader]Reliance on paper-based data“...another issue is just in terms of the integration of services, it’s really this way of working where we’re still very reliant on paper...” [Leader]Fragmented data (in discrete formats and locations)“...(we) collect a lot of data associated with both our youth as well as the services we’re providing. Then (there is data) on an ongoing basis (such as) case notes, service plans, all sorts of things... for each youth that we serve &...lot of cases, those pieces of information are in lots of different locations or different systems.” [Leader]Challenges associated with the pandemic“Staff development, the workload being too high, insufficient time, specifically over the last year during the pandemic.” [Life coach]An employee’s overall integrity and commitment to help clients achieve their goals is considered an indirect measure of their performance. Therefore, it is the quality and not the quantity of work that steers the performance evaluation . All emp“At least from what I’ve been able to see, and how I evaluate the employee, it is not really about the quantitative work, (it is) more about the richness of the work.” [Leader]This theme has subthemes that are explained in subsequent sections.Beyond the convenience of access and minimizing the gathering of paperwork, all respondents brought up the benefits of having a centralized electronic system in which data were entered and saved in real time. Rather than entering weekly contact notes (before the WCM), notes are being entered in a timely manner without waiting for weekly data dumps. Data could now be retrieved and viewed immediately from anywhere, anytime, and anyone from the team.WCM enhanced the usability and utility of youth information through the ability of configuration capabilities to retrieve and present desired reports. The participants discussed the importance of effective and efficient workflows and how this efficiency enabled them to rapidly triage vulnerable residents to the services they need in a quicker manner. This ease of access to a full synopsis of any client allows for flexibility in the performance of client duties. In an emergency, a life coach unfamiliar with a client could simply look up all their pertinent information. Although not a perfect solution, this capability did provide a significant improvement over the current workflow .Real leader time electronic data entry“Prior to WCM, (the life coaches) had to write down notes then go to the file cabinet to pull out notes or to put them into a file & so now with Watson, the notes get entered in real time... as they’re having their interaction with the young adult, they’re already typing in the notes.” [Leader]Effective or timely care delivery“...(the process is) transitioning...to a real time information mindset. In other words, the data isn’t updated once a week, or once a quarter. It is updated once a day; it's updated as frequently as it needs to be...Personally, I think that's a huge shift in the way people work & I think it’s a huge shift in the way people are able to kind of better manage their youth relationship.”Easy access to data“Before, you know, we just had it (paper records) in a chart room. You had to be literally in the office to find anything you wanted. So, it’s really great to be able to have that on hand, made it smoother & when, in emergencies or in crisis where you need to access that information quickly.” [Life coach]Participants believed that there were definite time savings realized after WCM implementation that indirectly or directly resulted in cost savings. Some of the reasons included saving time on commute due to convenient access to the tool, less overtime granted to catch up on notes, and more effective notes retrieval .Time savings“Case so absolutely, I would say a savings in the travel & the time in printing & scanning & in having to set up meetings because now it’s more collaborative & people are more up to speed or the cases.” [Leader]Cost saving as proxy of time savings“Because a lot of overtime was granted catching up on notes... there’s been tons of time savings... Watson is available on electronic devices. It’s mobile. They don’t have to come back to an office to write down their notes or to type things, & they’re doing it out in the field. I’m 100% positive that it has saved our life coaches a lot of time.” [Leader]According to the participants, their interactions with youth are much more enriched; that is, youths are more focused and engaged while managing their own care plans. There is consensus that youth outcomes are also improving, such as better retention, which could be further validated by examining objective data. However, the reason for these improvements may be multifactorial because WCM is only one of several modifications to workflows .Enriched interactions and better engagement“Definitely, I could see (improvement), like, it kind of helps to enhance in a sense because, like I said, the youth can more physically see what’s going on...so that does help because it’s (they) more focused...” [Life coach]“...but I think definitely (there is an improvement)...but from my observation (there is) an increase in youth engagement.” [Leader]Better outcomes“...[There is]decrease in voluntary & involuntary discharges. Some of the data that I’m seeing [outcomes] right now can I tie it to Watson 100% confidently? No! but I think that there’s a correlation.” [Leader]This theme has 4 subthemes explained in subsequent sections with supporting quotes.The tool served as a convenient, centralized system, with all youth information consolidated in one place, thus providing a holistic 360° view of any youth at any time .Centralized data hub“Oh, yeah, having Watson Care Manager keeps everything in the centralized system. That way we don’t have to go back and forth in between pulling up the youth’s goals in their folder. We have it all in our Watson Care Manager.” [Leader]Holistic view of youth profile“...here again, this kind of a 360 degree view that’s accessible to any member of a care team at any point.” [Leader]WCM helped all youth receive high-quality care, regardless of the complexity of the youth’s needs or the experience level of the life coach by rendering rich care plans with clear road maps. As stated earlier, many life coaches had heavy client burdens, and leaders found it difficult to hire new staff in the wake of the COVID-19 pandemic. As such, life coaches had large client loads, and a number of coaches had few years of experience. The large client list and complexity of each client case meant that each client required an array of assessments, documents, and other appraisals to ensure their health and safety . By embe“Say, if I’m putting in a safety plan, it will actually alert me to ask ‘did I contact any medical needs? Are the police involved?’ It (WCM)reminds me ‘hey, you need to check on these things’... So, you’re not like trying to go off of experience... I think really guides our best practice.” [Life coach]In this capacity, WCM functioned as a “memory bank,” ensuring that no tasks or actions needing attention are overlooked or missed action . This is“Watson will project for specific actions that need to be done to that task. So, say, for instance, if I put in a safety plan, it’s going to prompt me (and ask) have you done this, this, this and this? So instead of me trying to operate on memory, Watson’s actually projecting and saying, ‘stop! -do this right now or else’.” [Life coach]The integration of WCM with the CLS tool has provided us with an opportunity to follow youth progress in a more intuitive and efficient manner. Earlier, the role of the CLS tool was more for compliance checks but now it is being used more meaningfully :“I am very excited about the configuration within Watson to our Casey life skills tool. Traditionally, we use this tool and (it was) just filed away... it was more transactional compliance check, completed it every 6 months, and it was thrown into the file. (But) With the configuration that we did within Watson recently, we were able (have) the scores added to the thing in Watson and then we’re able to pull a report from Cognos to be able to demonstrate growth.” [Leader]The users mentioned several commonly used features. A few that were brought up repeatedly are alerts and reminders, automatic goals or action, configurability with CLS, touchpoint notes, youth photos, and the summary page .Alerts and reminders“Watson so that we get alerted when the system recognizes. Someone may benefit for mental health services so that the life coach, and the team is aware, and can provide those referrals to the community to address any gaps.” [Leader]Automatic goals, actions, and care plans“So, definitely the automatic goals action alerts. I think really guide our best practice and are used the most often.” [Leader]Configurability with Casey Life Skills“Casey’s (CLS) are actually interacting with the goals so that’s really nice. That’s a new feature that’s just kind of been developing. And so that’s really nice. I do like that. It promotes tasks. Like I said, I enjoy that too.” [Life coach]One of the initial expectations was that the new care management tool would make the completion of the processes and associated tasks more efficient and effective. Employees’ expectations were met by the tool’s implementation, as it brings all data into an electronic form and under one platform . Previou“One of the expectations (we had and) was not an immediate expectation. Something that would happen over time is that there would be kind of efficiencies associated with the work that a life coach did and improvement in their process... Being able to, you know, access data and enter data in the field to have data all in one place, as opposed to in a lot of different (place), you know, systems or paper files or whatever. And I think to that extent, Watson has met those expectations.” [Leader]Artificial intelligence technologies was an area where employees had higher expectations that they felt remained unfulfilled . They be“You know, I was expecting a robot to be honest almost. Maybe, I was not being realistic that (it) was going to take over (and) is going to help?? (us) through every single step...I had very high expectations of it and maybe unfair expectations of it, you know so I would say that while it has not fully met my entire expectation of it. You know, it’s making steps towards that very slowly...” [Leader]Having a client dashboard for users and to generate reports enabling them to see their client snapshots is another feature currently absent that would improve the workflow :“And so, like I said, it, that part has been hard to like (i.e.), to run a quick report...also our supervisors can’t (run reports), there is not like a quick dashboard. They would have to understand tables in order to go into Cognos and run the report to get that information.” [Leader]Integration of a sophisticated search engine to further expedite information retrieval was a commonly reported theme :“If you can search, like, a search window where you can type (such as), if you are looking for some specific doctor’s visit, so type in (doctor’s visit), and it pulls up all the doctor’s visit. Something like that.” [Life coach]Data management, such as automating the data population, the ability to bulk edit, and repeated data entry tasks, is believed to be suboptimal. Additional developments around these features could likely reduce the redundancy of task completion and hence enhance efficiency :“(Getting tasks done) is tedious (having), repetitive forms or repetitive actions and tasks or just having their name and birthday (repeatedly entered) in every form, it just gets to be too much...” [Life coach]Some of the recommendations made by the employees were enhancing the communications functionality within the tool; for example, provision of email or chat between supervisors and life coaches for quick communications :“Supervisor needs to review something that a life coach completed, there should be like a way to alert them through the tool. Or I feel like, in this case, it would be an email that needs to be sent saying, ‘hey, you have an alert on this client’.” [Life coach]When comparing pre- and post-WCM implementation satisfaction scores, as measured using a 5-point Likert scale, the scores remained constant between the 2 life coaches . Among leaders, the results suggest a higher satisfaction score for post-WCM implementation  when compared with pre-WCM implementation  was 18 (18-19) years, and 55.32% (614/1641) of the patients were female. The reported race or ethnicity data across this population included Hispanic or Latino , Black , White , and other  was 247 (125-468). School enrollment varied, with most youth enrolled full-time , some enrolled part time , or some not enrolled at all . Youth employment and available housing vacancy were 17.61% (289/1641) and 61.85% (1015/1641), respectively.For the 2 phases under study, the number of incidents (undesired events) reported was 842 and 2074 for pre- and post-WCM implementation, respectively. Providing extended foster care to help prepare disadvantaged young adults for transition into adulthood is a complex process. TAYs are often confronted with multiple challenges including social, emotional, physical, and mental instabilities  simultaneously. Existing processes around managing those processes are often fragmented and resource intensive, which can interfere with effective and efficient care delivery and desired youth outcomes. It is imperative for organizations to take actions to overcome such roadblocks . The implementation of WCM at Aspiranet to assist in managing the care of youth transitioning from foster care to adulthood has enriched workflow processes and is positively impacting youth outcomes by the transformation from a traditional paper-based system to an integrated and interdisciplinary technology-based system. Using WCM, Aspiranet’s leaders and life coaches can develop integrated care plans for youth under their management. WCM helps in successfully triaging the vulnerable youth population to the optimum services they need in a more effective and efficient manner compared with the former highly manual, paper-based processes. In terms of youth outcomes, the results showed an increase in full-time school enrollment and a reduction in part-time school enrollment. A greater availability of vacant residential options serves as a proxy for favorable youth behaviors. Landlords’ satisfaction is higher and their need has decreased in refuting TAY for housing privileges because of their hostile behaviors. The median number of days spent in the foster care program remained the same; however, the number of incidents reported per month per 100 youths showed a steady decline, even with an exponentially increasing number of enrolled youths .Analysis of the interview data revealed that the implementation of the tool facilitated streamlining the workflow and efficient retrieval of youth information. The data are accessible anywhere and at any time, in contrast to previous methodologies that require digging through file cabinets and driving miles to access data. Currently, with WCM, information is more accessible and thus more usable for life coaches. Users reported more meaningful and productive interactions with the youth under their management, and the availability of a visual representation of the youths’ progress and accomplishments enhances monitoring. Visualization helps develop hope and motivation among otherwise discouraged youth. Finally, quick access and sharing of information allowed users to respond to emergency situations faster, lowering the risk of undesired outcomes.As observed in previous studies, we found that when new technology is introduced, there is often a disconnect between leaders and staff as they see things differently . The samIn terms of youth outcomes, full-time school enrollment increased, whereas part-time attendance declined, indicating that youth were more focused and able to successfully compete their goals. Employment decreased, possibly because of the COVID-19 pandemic, and the state of California revised school attendance laws during the pandemic. No change was observed in the length of service . The data showed a significant increase in available vacant housing, which could be attributed to WCM. The explanation is that WCM provided a better picture and understanding of the maintenance needs of the apartment complex or residential units, which resulted in a more proactive response to apartment landlord needs and sustained a strong relationship. According to one of the leaders, retaining the existing landlord or apartment relationship is a key factor that allows the program to continue to grow. Without available apartments for placement, youths in the TAY program would not exist, and the foster care program would not be as successful as it is today.As the number of youths increased, the total number of undesired events such as fights, break-ins, falling grades, and police custody increased, but the monthly number of incidences showed a steady decline. This is promising and indicative of potential improvements in behaviors or actions.With respect to the interpretation of the abovementioned data, we need to keep in mind that these outcomes could be influenced by a number of other variables. Further analysis of quantitative data is needed to make any claims that the benefits surface from the use of WCM per se. The earnings from this study could be used as a springboard to further enhance future artificial intelligence–based technologies in social care management. This could be achieved by improving and fortifying the tool’s current strengths, identifying gaps from a larger group of diverse stakeholders, and addressing them to ensure that they align with their needs and improve youth outcomes.The study limitations include data challenges, specifically missing data and incomplete or even absent preimplementation use and outcome comparison data. This further illustrates WCM capabilities for storing and saving data in a more readily accessible and secure manner in a single place that is not previously available. Before WCM implementation, the data were recorded using pencil- and paper-based notes, spreadsheets, and databases with fragmented and missing information. A second limitation was a small interview sample size, especially with life coaches. A third limitation was the inability to interview the youth (vulnerable population) to gain an understanding of their perspectives.Most importantly, the improvement seen in workflow processes or youth outcomes cannot be fully attributed to the implementation of WCM because there are likely multiple confounders, both known  or unknown, which require further investigation.Foster care and social service agencies providing support to TAY are challenged by synthesizing large volumes of siloed data  to support high-impact decisions. A care coordination approach that is supported by technology has many potential benefits. These include serving as a common, shared platform to consolidate and manage electronic data and to create and track specific goals and corresponding actions. These complex processes are now executed more effectively, efficiency gains are realized in real time, with greater perceived acceptability to end users, and ultimately positive outcomes for these youths to become independent and productive members of society.


In doing so, we also demonstrate that the lexical item KENDİ in Turkish Sign Language  can function as a traditional reflexive, in addition to its previously documented emphatic functions. We further show that KENDİ is a DP-type reflexive, which helps to explain the emphatic usages of KENDİ that have been the focus of previous research. We end by outlining a plan for future research that can further probe and unify the superficially distinct functions of KENDİ and the typology of anaphoricity across modalities. Data for the present research comes from recently conducted fieldwork interviews with two signers of the İstanbul dialect of TİD, both of whom have been exposed to TİD since birth.Linguistic analysis is improved when it includes language beyond the spoken modality. This paper uses sign language data to explore and advance cross-linguistic typologies of  Conceptually, reflexivity is a specific type of dependency relation between two arguments of a predicate where the two arguments are co-referent. Languages of the world have different strategies to mark this relation (via reflexive pronouns (1).Sensitivity to event participant structure is evident in the earliest stages of language acquisition  and distrelation , as we dhenceforth, ASL). Though Stokoe made some observations regarding ASL syntax, his focus on the phonetics and phonology of signs left “much more” to do “in establishing exactly what are the structural principles of the sign language sentence” , which is produced by tapping in the middle of the chest with an open hand, fingers bent inward, as depicted in Our focus will be the lexical item KENDİ in the existing literature, much of it limited to in-passing observation that the sign KENDİ exists. KENDİ as a reflexive pronoun (2b):There has been little work on KENDİ can be used both as a traditional reflexive . Predicates like “bathe” can, however, express non-reflexive events, as with the transitive variant I bathed the dog in English. Lexical reflexives in English are also often compatible with (redundant) grammatical reflexivity, as in I bathed myself . Here, the reflexivity relation is not only expressed via the semantics of the verb but also the argument structure of the utterance. Grammatical reflexivity manifests itself either via marking on the verb (a) or marking on the arguments (b):The literature on reflexivity suggests that it is a universal part of language, observed in many languages across different language families, albeit encoded with different grammatical mechanisms. With respect to the strategies that encode reflexivity, we can talk about two main kinds of reflexivity: 2 is a verbal suffix. As for (3b), In (3a), the reflexive marker {-un}within the categories of verbal and argumental reflexivity marking. Verbal reflexivity includes affixes like -un- in Turkish (3a) and clitics, such as the French se in s’habiller (“to dress oneself”). As for argument marking, we observe both free standing reflexive pronouns such as zich in (3b) as well as bound morphemes that shift a stem to a reflexive meaning . It is not uncommon for languages to exhibit multiple reflexive strategies, or to combine them as part of a complex reflexive construction.There is also variation binding. Argument reflexives require being bound by a potential co-referent (4a-b) and are usually restricted as to what can bind them within what structural domain and/or configuration (4c-d), e.g., intra- or inter-clausal , or on the argument of the verb (6b):via the spatial agreement markers, indicated by the subscripted ‘‘a’’3. Here, the direction of the object agreeing verb’s path movement agrees with the subject, linking the grammatical object and the subject of the sentence in co-reference. ZELF in (6b), similar to English -self. This parallelism across modalities is not unexpected considering that reflexivity reflects event participant structure, which may be conceptually and linguistically fundamental. This parallelism aside, what sign languages bring to the table is the way they use space for reference, which may lead to modality-specific effects on reflexivity. The role of space in modulating reflexivity is evident in (6a). These reflexivization strategies are not specific to the exemplified languages. The verbal reflexivity of (6a) is expressed SELF in ASL can also functions as copula (7a) and as an emphatic marker (7b):The multi-functionality of reflexive markers is also relatively well-documented in sign languages. As an example, All in all, the existing work, though limited, shows that reflexivity in sign languages is compatible with certain aspects of existing typologies. However, it is also the case that sign languages can provide unique and novel data to further explore the phenomenon of reflexivity, including how usage of space affects referential relations . Before via Facetime and Zoom due to the limitations on travel and in-person meetings during the COVID-19 pandemic. The language of interaction was TİD, though both consultants also have proficiency in written Turkish. We have utilized acceptability judgments and having the consultant describe contexts and situations using KENDİ as methods of data elicitation. Only one consultant at a time was present for each fieldwork session. Because of quality issues that can arise in videoconferencing, the data reported here were also recorded separately by one of the consultants and can be accessed in an online repository (file names correspond to example numbers): https://tinyURL.com/KendiRepository.The data for this work comes from fieldwork sessions with two Deaf adult female signers of the İstanbul variety of TİD. Both have been exposed to TİD since birth. The sessions took place 2020–2021 and were conducted online KENDİ. Our aim here is to lay the groundwork for the more detailed discussion of the distribution of KENDİ in later sections.In the previous section, we described the basic patterns of where and how co-referentiality and, specifically, reflexivity is marked in language. In this section, we will look further into co-referential dependencies in TİD, and the core properties of co-referentiality marked by As noted above, co-reference is structurally constrained and certain classes of DPs are restricted in the co-reference relations they can enter into. herself has to refer to Zelda, as indicated by the subscripted referential indices. In (8b), the pronoun she has to refer to an entity other than Zelda. Lastly, in (8c), the possessive pronoun her allows reference to either Zelda or an individual outside of the clause, a discourse referent. The Binding Theory (In (8a), the reflexive g Theory  aims to In (9), we document these patterns in TİD:KENDİ in (9a) must refer to the subject, ELVAN, as indicated by the subscripted referential indices. This is obligatory co-reference, as one would expect of a traditional reflexive governed by Principle A. Skipping ahead to (9c), we again observe a familiar pattern: the sign name ELVAN and the 3rd singular subject cannot be co-referent. This is obligatory-non-co-reference, governed by Principle C. The structure that gives rise to optional co-reference ambiguity in (8c), however, patterns differently in TİD (9b) due to the spatialization of the possessive marker . Thus, we have obligatory co-reference with a non-reflexive pronominal not so much because binding works differently in TİD (9b), but because spatialization can prevent certain ambiguities from arising in the sign modality .Interestingly, optional co-reference ELVAN) by default/without special context . Ambiguity on a par with (8c), however, can arise due to the use of a null possessive. Because it is null, the possessive is not spatialized as in (9c). The null possessive can be co-referent with the overt (subject) argument  express a reflexive event. Unsurprisingly, that reflexive event can be described using an obligatorily co-referent reflexive pronoun (13a). The reflexive event cannot be described using an obligatorily non-co-referent R-expression (13c), nor can it be described using a non-reflexive pronoun (13b).KENDİ requires a morphosyntactic antecedent (14a), unlike a non-reflexive pronoun such as IX3sg in (14b) or an R-expression such as ELVAN in (14c). Moreover, as in (13), we see that only KENDİ can be used in a reflexive environment like (15).Parallel structural constraints hold in TİD. Like (12a), (14a) is ungrammatical because KENDİ appears to behave like a traditional reflexive that (i) requires a co-referential antecedent that is (ii) in the right structural configuration.Thus, These morphosyntactic constraints pertain to what is meant by “binding domain” in Principles A-C. Binding domains appear to be sensitive to structural proximity, often called locality, which we illustrate here with clause boundedness. The sentences in (16) present the three types of DPs in the object position of a subordinated clause in English, with their potential antecedent in the subject of the matrix clause.requires binding by an antecedent within its own local domain. This then would predict that if KENDİ is indeed a traditional reflexive, we should see evidence of structural sensitivity and locality constraints . The TİD equivalents of (16) are presented in (17), and the data in (17a) show that this prediction is borne out. (17a) is only grammatical when KENDİ is bound by an antecedent in its local domain (IX1sg_j) like in (16a), as opposed to an antecedent outside of it (ELVANi). As for the pronoun in (17b), we again observe the sentence is rendered grammatical as long as the pronoun is bound by a co-referent outside of its local domain, as opposed to being locally bound. Moreover, we see that an R-expression in TİD (17c) is degraded if it has an antecedent at all, even if that antecedent is in a different domain :The boundary between the matrix clause and the subordinate clause seems to also function to demarcate binding domains. Thus, the antecedent for the reflexive in (16a), as compared to (8a) or (13a), is “too far away” to satisfy its binding requirements. In the case of a non-reflexive pronoun, the added distance of (16b) relative to (13b) allows the optional co-reference to emerge. Lastly, (16c) affirms that co-referential dependency, even when not local, between an R-expression and a potential antecedent is ungrammatical. Recall that this dependency was ungrammatical when it was local in (13c), too. Focusing on the comparison of (13a) and (16a), these data show that a traditional reflexive KENDİ is only grammatical when bound by an antecedent that is syntactically proximal to it, such as (IX1sg_j) in (17a), as opposed to an antecedent outside of it (ELVANi). The basics of co-referential relations among nominals in TİD tells us that KENDİ behaves like a traditional reflexive. However, reflexives aren’t a homogenous class, and reflexives with different morphosyntactic and semantic encodings may be subject to different restrictions .KENDİ stands among reflexive markers, laying more solid groundwork for further analysis of KENDİ and co-reference relations in TİD. We begin by using KENDİ. The results of these diagnostics show that KENDİ behaves like a DP-type reflexive. The classification of KENDİ as a DP-type reflexive leads to predictions about its behavior and functions beyond marking traditional reflexivity, which we discuss further in “The Function of KENDİ Beyond Traditional Reflexivity.”One such difference is that the multi-functionality of the reflexive marker differs depending on its type. The typology laid out by m’ in (18), which is a reduced form of the pronominal me. As the gloss suggests, the reflexive clitic m’ forms a phonological unit with its verbal host (auto-suggère). Moreover, though French is typically a postverbal object language and m’ is expressing the reflexive object of the predicate, the clitic appears in a preverbal position. Thus, the clitic has characteristic properties in terms of its morphophonology and its morphosyntactic distribution.Much like traditional reflexives are semantically dependent on an antecedent, clitics are morphologically and phonologically dependent on a host. They cannot bear stress, and often come in a reduced phonological form, as exemplified by the reflexive clitic KENDİ is in the standard pre-verbal position, as illustrated in (9a) and similar examples. This distributional pattern is not inherently at odds with a clitic analysis, but if KENDİ were a clitic, we would expect it to form a phonological unit with a preceding or following element. However, as illustrated in (19), KENDİ can be morphophonologically separated from the verb (its following element) by an intervening adjunct  continues throughout the production of the verb, while the adjunct in (19b) is clearly sequential):Turning to TİD, a default SOV language, note first that the typical position of object KENDİ is also morphophonologically independent from the elements that precede it. For example, KENDİ is adjacent to its antecedent, ELVAN in (19a), but separated from ELVAN by the intervening adverb NOW in (20).KENDİ is not a clitic is that it can dislocate to the left periphery, giving rise to a contrastive topic meaning (21).Another piece of evidence that ELVAN. Therefore, (21) not only shows that KENDİ can be linearly dislocated from what would have been its most plausible host, but also shows that it forms its own prosodic unit. This, then, backs up the narrative that KENDİ is a morphophonologically independent form.In TİD, contrastive items are often observed with an eyebrow raise that is articulated simultaneously with the contrast-associated item , 2006. TKENDİ to other clitics that have been documented in TİD -namely, the clitic form of negation—also reveals differences. 5. In its cliticized form, negation loses its syllabicity  and assimilates to the location of its host, instead of the neutral signing position used in Comparing KENDİ does not get assimilated to that of its host. This could be due to the body-anchored nature of KENDİ. However, there are other ways KENDİ differs from the negative clitic. Building on Zeshan and Kelepir’s analyses, KNOW and cliticized ^NOT in Unlike clitic negation, the signing position of ELVAN too, had KENDİ cliticized to it. Thus, based on evidence from intervening items and the properties of clitics in TİD, the relationship between KENDİ and preceding or following elements is linear adjacency, not morphophonological dependency, as would be expected of a clitic.Here, too, (21) provides the relevant evidence: we might expect the eyebrow raise in (21) to spread onto em) in (22a), only the reflexive interpretation is possible.Bound noun reflexives are attested in languages such as in Halkomelem, where body part nouns attached to the predicate can be interpreted as co-referential with an argument, either the subject in an intransitive verb form (22a) or the object in a transitive verb form (22b). In the case of the predicate with an intransitive marker  languages. Moreover, sign languages often make use of space for modulating agreement, and we know that TİD is a sign language that marks agreement spatially (KENDİ is doing for two reasons: (i) it marks reflexivity without being assigned a locus and (ii) still allows the verbal reflexive agreement marker to appear  has the distribution of an object agreement marker in the morphological template of Shona6 :Before elaborating on those arguments, we first provide an example of a reflexive that is of the agreement marker type in Shona. The reflexive KENDİ, as compared to -zví, does not form a morphophonological unit with the verb. Indeed, KENDİ is not even obligatorily adjacent to the verb, as one might expect of an agreement marker in general. Moreover, KENDİ is body-anchored and does not make use of an assigned locus in the signing space. Thus, it’s quite unlike how agreement is marked in TİD , but present then the verb is used non-reflexively (24b):As for the intransitivizer category, As described above, TİD and other sign languages can incorporate spatial locations to mark agreement. TİD also displays object agreement on some verbs through palm orientation . In a sentence like (25a), the 3rd person palm orientation is toward a spatial locus away from the signers’ body, whereas in (25b) there is the reflexive marker KENDİas well as palm orientation toward the signer’s body, just like 8 Note that the signer has omitted the subject agreement marker in (25b), as has been observed elsewhere in sign languages  argument of the verb: it occupies an A position as the canonical object in the sentence and, moreover, can be dislocated to an A′ position the left periphery.DP reflexives are basically reflexives that act like any DP, except for the specific dependency relation that they require a co-referring antecedent. Previous examples have shown that myself. For KENDİ, the connection with possessives is twofold. One, KENDİ can be combined with an overt possessor like the English “xself”, as in (27).Recall that KENDİ itself can also be used as an independent possessive (28), though this usage isn’t very common.10Two, KENDİ block another possessive:There are also cases of complementary distribution, where possessive usages of With respect to reflexive multi-functionality, additional functions of the DP type reflexives that forms that are in grammatical positions that are not associated with reflexivity (emphatic anaphor), or have non-prototypical antecedents (logophor). We are currently investigating whether a logophoric usage of KENDİ possible, but we already know from previous observations by KENDİ does indeed function as an emphatic anaphor. We elaborate on the emphatic anaphor usage of KENDİ in “The Function of KENDİ Beyond Traditional Reflexivity.”As a reminder, emphatic anaphors are used to focus some aspect of the event or the referent’s role in the event, often from a non-argument position, and logophors are anaphoric elements that seemingly skirt binding principles by getting their co-referent from a discourse antecedent outside of their local domain. Thus, emphatic anaphors and logophors are reflexive KENDİ in TİD can function as a traditional reflexive, and its previously observed usage as an emphatic anaphor is connected to its status as a DP-type reflexive, similar to English xself, and unlike other syntactic categories of reflexives discussed above. Moreover, we have seen that KENDİ shares other features that characterize DP-type reflexives, such as a structural parallelism with possessors. In the next section, we further explore the traditional reflexive usage of KENDİ, providing a more detailed description of its binding domain and its antecedents.To summarize, our fieldwork reveals that KENDİexhibits behaviors consistent with a traditional reflexive. We have also argued that KENDİ is a DP-type reflexive. In this section, we will explore KENDİ as a traditional reflexive in more detail and discuss its relation to potential antecedents in local and long-distance binding domains. We first examine whether KENDİ can be bound by null antecedents as well as overt ones, and then the clausal location of these antecedents.We have thus far provided some basic observations regarding co-referential relations in TİD and shown that KENDİ by the contrast in (31), where (31a) contains an overt antecedent (ELVAN) for KENDİ and is grammatical, but (31b) lacks an overt antecedent and is ungrammatical.A defining characteristic of a traditional reflexive is that it requires an antecedent. Whether this antecedent must be overt or not depends on whether the language in question allows null arguments. This is illustrated for KENDİ can be licensed by covert antecedents. The data in (32)-(33) illustrate that this prediction is borne out (“e” glosses the position of the null argument):Judgments like those for (31a) and (31b) are in “out of the blue” contexts. However, language is rarely used in truly out of the blue contexts. Given that TİD permits null arguments, we would predict that KENDİ can be null arguments that are licensed by earlier portions of the discourse (32) or by contextual salience (33). Like KENDİ, the null argument that binds the anaphor, ie, is subject to its own licensing conditions . Note that the examples are structurally identical and Charlotta precedes the intended co-referential DP in both. Because Charlotta is “buried inside” the subject DP, however, it does not c-command the her/herself in either example. The resulting grammaticality differs depending on the use of a non-reflexive vs. reflexive pronoun. The non-reflexive pronoun in (34a) is grammatical because such pronouns are only optionally co-referent and do not need to be bound. However, a traditional reflexive is obligatorily co-referent, so the herself in (34b) does need to be bound. Consequently, expressing the co-reference via a reflexive, as in (34b), is ungrammatical.Crucially, there are patterns in language, like reflexivity, that show sensitivity to structural relationships like c-command. This is illustrated by the relationship between KENDİ, the possessor ELVANi and the full possessive DP [ELVANiPOSS3sg_iSISTER]j. Only [ELVANiPOSS3sgSISTER]j, however, is in a c-commanding relationship with KENDİ. As predicted, this is the only DP that can bind KENDİ:A similar example for TİD is presented in (35). Here, there are two possible antecedents for ELVANi cannot bind KENDİ tells us that TİD is no exception to the rule that the relation between the antecedent and a traditional reflexive is structurally determined, and one that cannot be characterized by linear precedence. Though critiques have raised questions about whether c-command accurately characterizes the structural constraints imposed on binding, what is relevant here is that (35) shows that there is a structural constraint at play. So far, we described what type of antecedents KENDİ can take and showed that it can be bound by both overt and null antecedents. Moreover, we have shown that the relation between KENDİ and its antecedent is subject to some type of structural constraint. To assess the proximity aspect of the antecedent-reflexive relation, we turn next to the pattern of KENDİ in subordinate sentences. In (36), KENDİ is in the object position of the subordinated predicate SEE, and co-reference with the subject (ELVAN) of the matrix predicate WANT is possible :The fact that . In (37), we see how KENDİ behaves when multiple possible antecedents are present in the sentence.Note, however, there are no other viable antecedents in (36)KENDİ is in the subordinate object position, but now two overt and distinct referents are available to serve as antecedents: the matrix predicate subject, IX1sg_j, and the subordinate subject, ELVANi. The only permitted antecedent for KENDİ in (37) is the closer subordinate subject. Note that the WANT type verbs in (36–37) are usually associated with non-finite sentential complements. In (38), we see the same binding patterns with THINK, a verb type that is often associated with finite sentential complements. There is currently very little known about finiteness in sign languages  within the existing literature, but the patterns are the same across these predicate types.Here, too, KENDİ is sensitive to familiar, structural binding constraints of hierarchy and proximity. Having elaborated a bit on the co-referential relations of KENDİ as a traditional reflexive, we will now turn to KENDİ’s function beyond traditional reflexivity, emphatic anaphoricity.Together, (35)-(38) show us that KENDİ has already been observed to be used as an emphatic anaphor , exemplified in (39). In (39a), himself creates argument focus on its event participant antecedent, a ‘‘specifically John and not someone else’’ meaning. In (39b), however, himself modifies the event (not an argument), and emphasizes that John performed the given event without help or the contribution of another causer/agent.11Emphatic markers are anaphors that co-refer to a participant of the given event to cast focus on it and to contrast it from other participants in a possible set of participants , i.a.. THe labels the interpretation that arises from modifying the DP (39a) as “adnominal”, and the one that arises from modifying the DP as “adverbial” (39b).KENDİ:In (40) we see the same two-way distinction with the emphatic function of himself and KENDİ.As the translations show, (39a-40a) and (39b-40b) resemble one another with respect to the emphatic contribution of himself in (39a-b) also correspond to different syntactic positions. Interestingly, the two distinct interpretations in (40) are possible with KENDİ in the same linear position. However, KENDİ in its emphatic function can also occupy different positions in the sentence (41), including the rightmost position (41c), which is ungrammatical for a traditional reflexive KENDİ as (42) shows  is optional):Notice, though, that the different interpretations of KENDİ has both adnominal and adverbial interpretive possibilities in each of these possible positions.Moreover, as the translations for (41a) and (41c) indicate, emphatic KENDİ: (i) denying the event, (ii) specificity, and (iii) thematic roles of the co-referent , this is accomplished by asserting that someone else did the activity. Denying the adverbial emphatic, however, doesn’t mean denying that the individual did the thing, just that they did the thing alone or without help. The felicitous adverbial denial pattern is given in (43b).both denials are felicitous with emphatic usages of KENDİ in each of the positions identified in (41)—that is, all three positions are apparently compatible with both adnominal and adverbial interpretations of KENDİ.In (44), we see that In addition to differences in deniability patterns, WHICH CHILD (46) and SOMEONE (47)—are semantically compatible with the adverbial interpretation of emphatic KENDİ, as in English, but they are also compatible with adnominal interpretations. Here, too, these observations hold for KENDİ in multiple positions.As for TİD, we again see a slightly different pattern. Non-specific referents—namely, KENDİ is perfectly acceptable and grammatical with a non-volitional inanimate subject, but that it is compatible with an adverbial interpretation (EXTCL glosses an extension classifier sign):The third and final diagnostic that we will cover from KENDİshows us that they have more flexibility than (i) their traditional reflexive counterparts in TİD and (ii) their emphatic anaphor counterparts in English. However, it is important to note that the semantics and pragmatics of TİD is very understudied, as is the cross-linguistic typology of emphatic anaphors. Future investigation can investigate the source of these cross-linguistic differences and further assess if there are differences between adnominal and adverbial interpretations of KENDİ.So far, our assessment of the emphatic usages of KENDİ can be ambiguous between a traditional reflexive and an emphatic anaphor. Such cases are possible when the predicate of a sentence allows for object drop or null objects and a potentially reflexive event. The predicate VOTE GIVE can take a DP (49a) or PP (49b) as an object, and it also can be used intransitively (49c):In this section, we will explore cases where KENDİ occupies an argument position as a traditional reflexive, or whether it’s an emphatic anaphor, and within the latter both adnominal and adverbial interpretations are possible.Thus, in (50), it is not clear whether KENDİ surfacing in the same linear position, it occupies different positions in the sentential structure. The intended interpretations can be contextually disambiguated but they can also be structurally disambiguated12. Examples of structural disambiguation are illustrated in (51), where the presence of a preposition (51a) or a separate DP (51b) unambiguously express the intended transitive interpretation  that VOTE GIVE can take its object as a DP or PP, which is why the FOR is “optional”).We assume here that this is a case of structural ambiguity: despite KENDİ that is compatible with different types of interpretations. However, there are also cases where we see multiple tokens of KENDİ within the same utterance, as in (52).The above examples are cases where we see a given token of KENDİ functions in a similar way to focus doubling , it might be the case that the doubling of doubling . The secKENDİ in TİD, which we argue can serve both a traditional reflexive and emphatic function. We have shown that KENDİ in TİD can function as a reflexive in the traditional sense and we have used syntactic typologies to classify it as a reflexive of the DP type. As a reflexive, KENDİis subject to structural antecedence requirements. As a DP-type reflexive, KENDİ is able to serve functions outside of traditional reflexivity.In this paper, we discussed the co-referential properties and the syntactic category of the sign KENDİ as well as reflexivity in TİD and other sign languages in general. With respect to TİD, future research can expand our understanding of (i) the shared and different properties of the traditional reflexive and emphatic function of KENDİ, (ii) whether these properties are associated with distinct merge positions in the sentential structure, (iii) if logophoric usages of KENDİ are possible, (iv) non-manual characteristics of these distinct functions functions, and (v) potential language contact and bilingualism effects, among others. Moreover, future research can explore these issues in other signed languages, and further contribute to a cross-modal understanding of how co-reference is encoded.Importantly, this study lays the groundwork for further analyses of The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.The studies involving human participants were reviewed and approved by Institutional Review Board of University of Michigan. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements. Written informed consent was obtained.DK conducted the fieldwork and drafted the manuscript, with critical revisions provided by NA. Both authors discussed the literature reviewed, designed the content and structure of the article, and approved the final version of the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.