Empirical Software Engineering rests on the understanding of practical problems and their solution counterparts. Frequently, solutions are not absolute but relative to the context where the problem is observed. This tends to imply that the solution and the problem unveil gradually together, and hence, researchers are not always in the position to state the research question (RQ) at the onset. Like software engineers when facing blurred requirements, researchers might not be familiar enough with the problem in the early phases of a research to properly scope their RQs (hereafter referred to as RQ Scoping). Here, the literature may play the role of the stakeholders in Agile methods: keeping the focus on the aspects that are essential  of the RQ. Informed by Inductive Top-Down Theorizing, this article acknowledges RQ Scoping as iterative and incremental, entailing a conversation between the experimental work and literature reviewing. Yet, for literature reviewing to become “Agile” it is not only required to be driven by the RQ but also to have tool support. Tools might bring transparency and traceability, both factors especially welcome in a scenario characterized by testing (is my RQ relevant?) and adjustment (how can I make my RQ relevant?). Specifically, the advent of the RQ in close relationship with the literature advises for “Agile” literature reviewing to be conducted at the place where the literature is naturally kept: the Reference Management System . This article introduces the theoretical underpinnings, design principles, proof of concept and evaluation for FRAMEndeley, a Mendeley-integrated utility for RQ Scoping. RQ Scoping extends the traditional notion of problem formulation  of the RQ. Second, Agile development advances iteratively and gradually through sprints. Likewise, coming up with a RQ is not a one-time activity but the RQ unveils as new or refined insights emerge. Third, Agile aims at an early and continuous delivery of working software. Likewise, RQ Scoping aims at producing successive versions of the RQs that “work”, i.e., that promote reflection and analysis through Comparative Thinking. Fourth, Agile is not about tools, but tools were key for Agile to become mainstream . Smooth adoption of RQ Scoping also rests on the existence of tools that support iterative and long-lasting reviewing sprints. Besides performance, tools bring transparency  and traceability , both factors especially welcome in a scenario characterized by testing (is my RQ relevant?) and adjustment (how can I make my RQ relevant?).RQ Scoping is particularly relevant for novice researchers. To many postgraduate students, finding the “right” direction in the literature maze is a particularly grueling experience Kwan . Novice In ESE research, how would RQ Scoping be operationalized as a RMS utility with a focus on postgraduate students?In short, if RQ Scoping is the aim, then “Agile Literature Reviewing” might well be the means. Specifically, the advent of the RQ in close relationship with the literature advises for RQ Scoping to be conducted at the place where the literature is naturally kept: the Reference Management System (RMS). RMSs like Mendeley, Zotero or EndNote are nowadays common among researchers  is an “answerable inquiry into a specific concern or issue” Studycom . The relknowledge questions that focus on “the what”, design questions move to “the how” by producing prescriptive knowledge to apply in context design an When compared with other scientific fields, a relevant part of ESE is problem-solving, i.e., designing artifacts as solutions to mitigate a problem. Unlike Wieringa . This coWieringa . Hence, Wieringa . AccordiWieringa  introducWe will refer to this template as CGAR (pronounced like “cigar”).Researchers approach the literature with different purposes. This section frames RQ Scoping within other processes where the literature also plays a key role: Systematic Literature Reviews, Schema Development, Grounded Theory, and Abductive Reasoning.Systematic Literature Reviews (SLRs) aim at coming up with the “map” of a profession, theory, or practice, normally at a given point in time , Grounded Theory (GT) is a method of inductively generating theory from data , later amendments consider that initial data may lead the researcher beyond empirical observation to engage with the literature in the search for novel explanations and theory constructs (aka Constructivist GT)  from the scene of a crime in ascertaining the suspects . Besides empirical data, researchers have an additional source of information: the literature. The researcher’s attention can be focused by his knowledge and scholarly context  but also informed by the literature. The weight that each of these informants  have on the abductive process results in different degrees of “inductive-ness” and “deductive-ness”. When it comes to literature reviewing, the main driver is now affinity, i.e., finding articles that might challenge the researcher’s hypothesis. Here, the literature review does not aim at covering all articles about a theme nor finding the most influential ones but rather, challenging the researcher’s assumptions. Unlike some SLR interventions, the goal is not so much “gap spotting” but problematizing the literature.Abductive Reasoning entails three main steps Walton . It starIn Social Sciences, an early attempt to apply this approach is the Inductive Top-Down Theorizing (ITDT) model  by challenging the researcher’s assumptions.Broadly, RQ Scoping can be described as Abductive Reasoning “in-the-small”. RQ Scoping is “small”: it does not aim at coming up with a full-fledged theory but just a RQ, i.e., a question that merits scientific investigation. To this end, RQ Scoping sticks to Abductive Reasoning. Broadly, the RQ plays the role of a hypothesis about the originality of the research. The literature is the Acid Test. During the test, researchers follow Comparative Thinking, which can be regarded as the counterpart of GT’s “constant comparison” In this setting, literature reviewing is recurrent and contingent. The RQ is tentative. The CGAR template might still be in an embryonic state with a blurring understanding of the key factors that capture the essence (in contrast with the accident) of the Context, Goal, Artifact, and Requirements. In this scenario, literature reviewing might not afford to be “systematic”. An Agile approach might be a better fit. In this comparison, the application requirements and the stakeholders find their counterparts in the RQ and the literature, respectively. Like software engineers, researchers might not be familiar enough with the problem in the early phases of a research to properly scope their RQs (the counterpart of the application requirements). To combat this, Agile resorts to an iterative and gradual development process . Likewise, RQ Scoping becomes “agile” insofar as the RQ unveils gradually and iteratively as confronting the literature by means of Comparative Thinking.Figure This section introduces the RQ of this work. Yet, it is not the destination (RQ) but the journey (RQ Scoping) that matters. Though a bit premature in introducing some concerns that are developed later in the article, the narrative of this section illustrates the sort of journey we want to give support to. Throughout this journey, different “sprints” were conducted with the set of articles ranging from thirty to eleven, accounting in the end for around eighty articles consulted.The journey may start with an intuition, perhaps a gut feeling from the student’s supervisor. This is RQ v0 see Fig. . It is nOn the problem side, the student notices that excerpts introduce different ways for helping with the Goal: “to come up with a RQ”. She abstracts away from the wording of the excerpts, and introduces three codes: synthesizing, gap spotting and schema extraction. Later on, when reviewing studies from Social Sciences, the student unveils a new Goal: theorizing for supporting nascent theories through Abductive Reasoning  and how they are read (contrasting with one’s work). The latter is especially relevant. As an abductive process, RQ Scoping intermingles induction (looking for themes via GT) and deduction (looking for hypotheses via Comparative Thinking). GT accounts for inductive reasoning, i.e., it lets the salient concepts arise from the literature. For instance, when looking at excerpts describing Artifacts, concepts such as “Type”, “Architecture” or “Approach” arise. We do not know which of these concepts will become essential  to profile our work. All induced concepts matter. You can try to see the generality of these concepts by using them to characterize additional works (deductive reasoning). This is the prevalent way in literature synthesis. Yet, RQ Scoping goes a step forward. Existing concepts, or better said, the way these concepts are combined in the RQ template, should be opposed to existing works. Broadly, the RQ plays the role of a hypothesis about the originality of the work. The literature is the Acid Test. During the test, some concepts might go away  while brand-new concepts are introduced . Here, “plug-in” does not arise through coding (induction) but as a sort of “gut feeling” ; “plug-in” is a bet the researcher makes in the pursuit of originality and relevance. This bet is put to the test in “the roulette of the literature”: has RQ v2 been already investigated? Is there someone else that resorts to plug-ins for QDA or SLRs?In the end, around eighty studies have been read In short, Systematic Literature Reviews and Agile Literature Reviews are two means with different ends. In Systematic Literature Reviews, the output is the answer to the RQ of the SLR, where replicability and thoroughness are critical for gaining trust from the target audience: the community. By contrast, in Agile Literature Reviews, the output is the RQ itself, and agility and interoperability with RMSs are critical for being adopted by the target audience: the reviewer herself. We can then conclude that RQ Scoping exhibits some specifics, distinctive enough, to vindicate the existence of dedicated tools: the Scoping utilities.This section generalizes the Design Principles (DPs) derived from the experience of leveraging a RMS  with RQ Scoping capabilities . A RQ is a set of pairs  with t∈T ∧ c∈CT where each pair positions one’s research along the design dimensions captured through T.Let T be a set of meaningful themes that characterize both the problem space and the solution space. Let CFor the purpose of this work, a Scoping utility is an IT artifact that helps in coming up with a RQ in close relationship with the literature. We advocate for RQs to be described in terms of themes. A “theme” is defined by DeSantis and Ugarriza , p. 362 Research Question variable (RQ) as “the theory”, and the Related Work variable (RW ) as “the ground data”. Next, we introduce a set of mechanisms for making these two variables evolve in unison , RQ Scoping becomes a GT endeavor. Operationalization wise, RQ Scoping involves the joint and gradual evolution of two variables: the Provide the RMS with a CGAR template in order for researchers to set CGAR as the departing themes for RQ definition.(DP1) The RQ variable starts off from Wieringa’s  templateProvide the RMS with RW-amenable folders in order for researchers to seamlessly promote existing folders to become RW variables.(DP2) The RW variable keeps the articles that help scope the RQ through CGAR-based coding. Yet, not all articles are worth coding. Articles are first scanned, and only if judged of interest, are then moved to the coding stage. If the literature is kept in a RMS, then potentially interesting articles can be easily put aside by moving the article to a dedicated folder. Alternatively, the reading of the articles might precede the emergence of the RQ. Good practices for arranging read articles is based on folders. A RQ could arise from any folder. Hence, any folder in the RMS could eventually become a RW-amenable folder. Provide the RMS with sharing facilities in order for researchers to unveil their progress to their peers.(DP3) Research is rarely a secluded but a collaborative activity Ellemers . This miIn Vivo coding). Ideally, this set of codes is mutually exclusive and/or well-defined from earlier literature (aka a priori coding). The CGAR template is a case in point. Here, we take Context, Goal, Artifact and Requirements as the initial codes to label excerpts. In this way, each article in the RW turns into a case in which to spot these four concepts.Once articles are moved to a RW-amenable folder, coding starts. Coding implies two tasks: data extraction and code assignment. Data extraction results in a set of “excerpts” for each article. Collected excerpts under a theme are next re-read for the codes to emerge. Codes are realized as descriptive labels that directly describe or are taken from the text (aka NVivo). Here, colors stand for codes , and color-coding highlighting serves to both extract and assign codes to excerpts. Color-coding is one of the most valuable affordances of QDA tools. RQ Scoping sticks to this mechanism. Provide the RMS with color-coding highlighting in order for researchers to seamlessly conduct coding.(DP4) To this end, advanced QDA tools resort to color-coding highlighting  Our setting is not a priori coding, i.e., the coding scheme can be open and emerge during the coding process itself. Excerpts from RW inspire new codes, which, in turn, might lead to reconsider the current RQ, moving from RQ to RQ’, i.e., changing (some of) the  pairs. This might involve re-coding some of the studies in the RW. The researcher might need to go back to earlier read articles and/or excerpts. Hence, revisiting formerly read articles is an important part of open coding Ortlipp . (DP5) PProvide the RMS with the ability to query bibliographical databases based on the current RQ in order for researchers to effortlessly shift in focus on the related work to be considered.(DP6) Better profiling the research question  might cause a shift in focus on the related work to be considered, i.e., moving from RW to RW’. After all, the significance of the RW is not about size  but the extent these articles confirm/defy the current RQ. In Glaserian GT, theoretical sampling is a way of collecting data, and deciding what data to collect based on the theory and categories that emerge from the data. In our setting, RW and RQ are the counterparts of the ground data and the theory, respectively. Therefore, our way to make RW evolve can be characterized as “theoretically sampled” insofar as the theory  drives the next RW sampling . If RW sampling is realized in terms of queries upon bibliographical databases, then these queries are to be constructed out of the current RQ. If the RQ is a set of  pairs, then the query is an AND connective of (t=c) expressions. Unfortunately, bibliographical databases follow slightly different query languages, hence the Boolean connectives are expressed differently depending on the targeted database. Therefore, Scoping utilities should help with the construction and mapping of RQ-driven queries targeted to potentially more than one bibliographical database. Provide the RMS with means for splitting, merging, adding or renaming of themes in order for researchers to conduct axial coding, and better discriminate one’s work.(DP7) Glaserian GT follows an inductive approach to theorizing: from transcript data to concepts. Firstly, codes are created through Open Coding and, after, they are grouped by similarity of meaning, originating the first themes (aka categories). During Axial Coding, these first themes might be clustered around more abstract themes, leading to a hierarchy of themes. Our approach is not fully inductive. We start with CGAR as the overarching themes. Confronted with a given RW, the researcher wonders what are the essential  characteristics of her own work insofar as providing a new solution to an old problem, or appropriating an existing solution to address a new problem. To better profile one’s work, CGAR themes might need to be refined. In other words, the RQ is in flux. Operationalization wise, this results in a frequent splitting, merging, adding or renaming of the CGAR constructs. “Splitting”, “merging” or “renaming” describe functional requirements but not the quality of how these operations are conducted. In this regard, two issues emerge.First, Axial Coding is a critical step better framed as a collaborative effort where postgraduate students work in tandem with their supervisors. Comparative Thinking is not a secluded activity. Hence, finding appropriate visualizations turns pivotal to support collaborative Comparative Thinking.Provide the RMS with means for comparative analysis in order for researchers to track the progress so far, facilitating Comparative Thinking and a fits-and-starts way to scope the RQ.(DP8) Second, in Agile Literature Reviews the Axial Coding is an activity sustained over time. By contrast, QDA and SLRs tend to be one-shot efforts. They start and eventually come to an end without main disruptions. By contrast, problem-solving ESE encompasses both problem understanding and solution development . Therefore, RQ Scoping might require a halt in keeping up-to-date with the literature in order to build  the artifact. RQ Scoping is marked by fits and starts rather than a steady progress. Here, resumption utilities come in handy to facilitate a quick recovery of the mindset previous to the interruption. Provide the RMS with chronological code-books in order for researchers to support transparency, replication and eventual backtracking.(DP9) RQ and RW evolve in tandem. To ensure coherence in coding criteria throughout, code-books permit to trace back the process of synthesizing the codes and translating them into themes, improving the soundness of the study , a given set of affordances  will hopefully accomplish stakeholder goals, . Table FRAMEndeley, a Scoping utility for Mendeley. Elsevier’s Mendeley is at the very top of the RMS rank  holds the excerpts that characterize article “a” with respect to theme “t”. Figure RQ variables are fleshed out as the first row in the Scoping Canvas. The cells of this row hold the codes that characterize one’s work according to the themes identified so far. For a start, RQ holds {, , , } where “n.y.a.” stands for “not yet available”. Unlike the rest of the rows that are automatically filled up based on the highlights of the articles, the RQ row is directly handled by the researcher.. FRAMEndeley constructs a query string as a conjunction of “t=c” expressions. This is supported through the Search String row  for its Theme Canvas to show up. Figure In addition, the reservoir of excerpts-by-article also comes in handy. Here, the researcher wants to have the overview of the whole article to better ascertain the most adequate codes. This results in the Article Canvas, a layer on top of Mendeley’s document viewer that displays how this article is arranged along the current themes see Fig. . Both thTheoretical sampling implies themes/codes to be in flux. At the onset, FRAMEndeley provides the CGAR themes. Throughout the research, these themes are elaborated, i.e. removed, renamed, split see Fig.  or mergeCode-books sustain coherence throughout the coding process. Boyatzis  recommenRQ Scoping is marked by fits and starts rather than a steady progress. FRAMEndeley helps moving in and out during RQ Scoping. First, the Scoping Canvas provides an overview of the progress so far: which articles have been coded or how they have been coded. In this way, the Scoping Canvas provides an outline of the RW at a glance. The canvas becomes a sort of map of the research space being investigated. During the research, the extent of the change in the RW is expected to be asymptotic, i.e., frequent shift of articles at the start to be later toned down as the researcher gains more accurate insights about both the problem and the solution.FRAMEndeley provides utilities to export the Scoping Canvas in either CSV or LaTeX format. This includes not only the table as such but also the bibliographical references . Table Mendeley allows for folders and highlights to be shared among users through Mendeley groups. FRAMEndeley taps into this capability by making the Scoping Canvas part of the group sharing. In this way, distinct researchers can work on the same related work and code-book. No new gesture is needed.7Table what is the role played by FRAMEndeley in promoting “agility” in RQ Scoping?This section describes the design, execution and results of a focus group to assess this question, which was conducted following the guidelines in Kontio et al.  to the process . Hence, the expected utility of FRAMEndeley should not be judged so much for the goodness of the final RQ but the quality of the process to reach this RQ in partnership with the literature. This “quality” is set in terms of “agility” i.e., the ability to move quickly and easily in the interplay between CGAR-driven thematic elaboration and Literature Reviewing. Therefore, the RQ of this evaluation is: o et al. .A focus group is a group interview involving a small number of demographically similar participants who have common traits or experiences  to 10 (most useful). Figure Participants agreed that their journey departed from general articles on the field , to later narrow the focus towards a particular problem or an existing solution. When it comes to the start-up effort: “I tried NVivo back in the day and it was a very complete tool, but very difficult to start-up. In this aspect FRAMEndeley is well integrated within Mendeley and very easy to start-up”. Participants highlighted the synergistic integration with Mendeley: “I think that both Mendeley and FRAMEndeley fit rather well. Mendeley helps you to organize your articles and access them easily. ... And next, FRAMEndeley helps you to visualize what you have done so far, to structure it or to conduct searches in the literature”. However, some concerns were raised regarding FRAMEndeley’s dependence upon Mendeley: “if Mendeley makes a change, FRAMEndeley might fall apart”.The three participants reported the use of FRAMEndeley for exploration purposes, i.e., to elucidate a suitable research path through literature navigation. As one of the students indicated: “we are thinking of using DevOps but I have a very basic knowledge of DevOps. So, what I have done first is to immerse myself in the DevOps literature and what problems or what casuistries are there in that area of DevOps, and then, I have tried to focus a little on the problem that I want to solve, or, better said, the problem that I suspect that may exist”. In addition, two participants highlighted the utility of FRAMEndeley for writing the Related Work section of articles. As one of the students explained: “when it came to writing an article, FRAMEndeley helped arrange related work by focusing on the concepts that make a difference. We had already developed a first solution and we wanted to focus a bit on what the competing options were and how we differed, how we improved, or how our problem setting differed from other studies”. Another recurrent comment was the ease of rearranging themes and moving codes from one theme to another in the Scoping Canvas. Last but not least, the fact of reading with a focus on the CGAR themes was also regarded as beneficial for speeding up reading. Yet, as argued by one of the participants, this can be a double-edged sword: “if themes are preset and I only focus on those ... it could happen that I am overlooking some other aspect that could be important later”. What if you come across an interesting text fragment that cannot be accommodated within the existing themes? All the participants found a workaround by creating a catch-all theme for gathering those interesting ideas that did not fit existing themes. In this regard, participants appreciated the Article Canvas as for the immediacy to remember what an article was about.When asked about their workflow, participants described an iterative process comprising several small sprints: “most times, I don’t do the coding of a single article, but I highlight some of them, three or so in one go, and then I go to the Theme Canvas and code those three articles, because seeing the comparative helps me to see whether I need to define new codes. ... Before advancing or adding more articles, I see what the previous ones were about”. Besides, participants agreed on the usefulness of having different canvases, and most importantly, on being able to easily shift between them: “navigating between FRAMEndeley’s different canvases is quite fast. ... In general, everything is well integrated and in one or, at most, two clicks you get from one to another”. Another recurrent theme was FRAMEndeley’s fit within participants’ way of understanding research, and especially, its support for collaboration. As one participant said: “in the end, research is essentially collaborative. And sharing the work in the same folder opens the door to having more than one person working on it, and you can even divide the work using the same code-book”. This view was echoed by another participant, who added up: “it comes in handy not only to divide work, but also when you meet [your supervisor] and want to talk about the comparison that you have been doing, the fact that everyone has had access to the analysis and shares the same vocabulary greatly facilitates the discussion”.Broadly, a workflow pattern seemed to emerge that starts with supervisors pointing out some “seminal readings”. This initial reading led students to come across other articles of interest. The Scoping Canvas seemed to foster Comparative Thinking. Thematic splits tended to be consulted with the supervisors.Back to the RQ of this evaluation, the role of FRAMEndeley in promoting “agility” seems to rest on two main enablers: the shallow learning curve  and the fostering of focus . On the downside, participants worried about the lack of portability and fragility of FRAMEndeley upon Mendeley client-side implementation. An interesting insight was a potential “channel effect” on the CGAR template that might prevent students from thinking laterally, considering concerns other than those tackled by the current themes.We consider threats for qualitative research as described in Maxwell .Descriptive Validity refers to the accuracy and completeness of the data. We transcribed the session and took notes about participants’ reactions. Moreover, we asked for clarifications from the participants on the doubtful extracts of the discussion.Interpretive Validity refers to how well researchers capture participants’ meaning of events or behaviors without imposing their own perspective. To improve interpretative validity, we began the session with a brief presentation on the objectives of the study and the proposed intervention. This presentation was aimed at establishing a common terminology and avoiding misunderstandings. Apart from that, we confirmed the conclusions of the focus group by soliciting feedback from participants. Moreover, the transcript was translated from Spanish to English, but the data analysis was made with the original Spanish version so as not to alter participants’ intended meaning.Theoretical Validity refers to the extent to which researchers provide an accurate and coherent explanation of the phenomena. The main threat to theoretical validity is concerned with the thematic analysis of the data. We tried to mitigate this threat by carrying out several iterations of coding, followed by discussion among the two authors of the article.Generalizability is concerned with the applicability of conclusions to similar settings and groups  , one of the most frequently used models of IS/IT adoption , and nearly two thirds were female. With respect to their educational level, 55% of the sample were pursuing a MSc (n = 11/20) and the remaining 45% a PhD (n = 9/20). In the latter case, participants also differed in the stage of their doctorate: 22.2% (n = 2/9) were in their first year, 11.1% (n = 1/9) in their second, 22.2% (2/9) in their third and the remaining 44.4% (4/9) were in their fourth year and beyond.The questionnaire contained two separate sections. Section A requested socio-demographic information. Section B examined the factors affecting students’ behavior along with measurement items proposed in the UTAUT model  technique was employed to estimate the effects among the hypothesized constructs (Russo and Stol α and composite reliability (CR). Table α topped 0.70.The first step of the process was to endorse the reliability and validity of the measures. The internal consistency and reliability of the constructs were assessed using Cronbach’s Convergent validity was evaluated by examining the standardized factor loadings and average variance extracted (AVE). According to Fornell and Larcker  and HairDiscriminant validity was examined through the Fornell-Lacker criterion, by comparing the square roots of the AVEs with the correlations among constructs to ensure that each factor was different, or uncorrelated. Table In the second step of the PLS-SEM approach, i.e., the structural model, the relationships between the latent variables were examined. Table β1 = 0.555, t-value = 2.091, p < 0.05). Hence, H1 was sustained.Particularly, H1 examined the relationship between performance expectancy and students’ behavioral intention to use FRAMEndeley. Table β2 = 0.105, p > 0.05 and β3 = − 0.111, p > 0.05) showed that both factors had insufficient impact on students’ behavioral intention. Thus, both H2 and H3 were rejected.Next, H2 and H3 determined whether students’ behavioral intention to use FRAMEndeley was significantly affected by effort expectancy and social influence, respectively. In this respect, the PLS-SEM findings . Therefore, H4 was endorsed.Finally, H4 tested whether facilitating conditions had a significant impact on students’ behavioral intention to use FRAMEndeley. The results show that facilitating conditions were a significant contributing predictor of students’ behavioral intention , ample adoption might still require ITDT to be framed at the users’ existing tools . This suggests that embedding ITDT as part of the RMS rather than as a dedicated tool The evaluation does not provide any conclusion as for the impact of facilitating conditions (H2) and social influence (H3). The fact that FRAMEndeley is a browser extension, and hence, most students are familiar with this practice explains H2. As for H3, we conjecture that the unawareness of ITDT among the SE community might explain that not only students but also their supervisors might ignore this method, and hence, we cannot pretend they “support the use of FRAMEndeley”.Finally, H4 insists on the importance of a proper setting to conduct ITDT. Unlike the traditional use of GT in Social Sciences, ITDT is a continuous effort. From the onset, and well into the project progress, researchers need to place their insights and solutions within a flux of articles while periodically shifting to artifact development and evaluation. In this back-and-forth setting, knowledge (FC01), tool compatibility (FC02) and assistance (FC03) are a necessary scaffold.For experimentation in SE, we consider here the threats reported in Wohlin et al. . The useThis study has several limitations. First, this study was conducted within a short period. Students’ perceptions of UTAUT constructs can change over time as new knowledge and experiences are accumulated. Therefore, future studies could employ a longitudinal design to obtain more accurate findings in a more realistic scenario. Second, although social influence is a UTAUT construct, the importance of the student’s supervisor advises to capture this factor as a separated moderator in future studies. Third, results are based on participants’ perceptions and impressions after “playing around” with the tool. This may reduce the soundness of the results. Finally, the number of participants in the study was limited (N = 20). We do not aim at a conclusive evaluation of what is an explorative study. The novelty of the tool, the context diversity where RQ Scoping is conducted, and the continuous nature of RQ Scoping, call for varied longitudinal studies that reach out to distinct research groups.FRAMEndeley (and one video) to Chrome’s Web Store and we waited to see whether participants found FRAMEndeley useful to the extent of installing it. As of June 2022, more than two years after the evaluation took place, FRAMEndeley installations scale up to 500 users. Figure As a first step, we tracked whether subjects kept using FRAMEndeley once the evaluation was over. To this end, we uploaded FRAMEndeley provides evidence of enough “perceived utility”. Moreover, the fact that the number of users has remained steady for more than two years points to sustained interest as evidence of utility. However, the main threat to construct validity of this evidence is to interpret “installation” as “real use”. While using Google as a data source provides credibility, it goes with the penalty of not having direct access to‘the users.In this trial, “software installation” is regarded as a proxy for utility. It can be argued that the discretionary effort of installing qualitative evaluation through a focus group (N = 3). Next, we move to a quantitative evaluation through a UTAUT questionnaire (N = 20).This work tackles a problematic phenomenon  by introducing an intervention , especially for a given target audience . We now revise the contributions stated at the introduction. First, we introduce RQ Scoping as a problematic practice, specifically in problem-solving ESE, and make a case for the use of ITDT as a promising methodology. Second, we elaborate on design principles for tools that support this practice, advocating for RQ Scoping to be framed within RMSs. We provide a proof of concept through FRAMEndeley. Third, given the exploratory nature of this research, we follow a mixed methods approach to evaluation. First, we resort to a Results from the focus group suggest that the “agility” of FRAMEndeley rests on two main enablers: the shallow learning curve  and the fostering of focus . As for the UTAUT evaluation, “perceived utility” and “facilitating conditions” are regarded as the main drivers for the intention to use FRAMEndeley. As for “effort expectancy” and “social influence”, no conclusion could be drawn. The drawback that “intention to use” does not necessarily imply “real use” was lessened by reporting data from Chrome’s Web Store where the FRAMEndeley extension enjoys over 500 installations at the time of this writing.Future work includes a detailed evaluation of the tool as a whole but also for each of the mechanisms that FRAMEndeley puts together . All in all, FRAMEndeley “just” helps with the organization and tracking of excerpts and related work. Yet, the selection of themes and codes, and the Comparative Thinking this involves, is within the realm of human ingenuity. This moves to the foreground “social influence” and the role of the research community to discuss the interest of “Agile Literature Reviewing” to complement “Systematic Literature Reviewing”, specifically for novice researchers.


Increasingly frequent humanitarian emergencies are highlighting the need for more effective collaboration on water, sanitation and hygiene response. Lynn Eaton reports. Omar El Hattab will never forget the night the children were killed in Aleppo. He was in the Syrian city at the time, leading the United Nations Children’s Fund (UNICEF) response to a humanitarian crisis that had flared up when groups opposing the government had deliberately cut off the water supply to part of the city, leaving 1.5 million people without running water.“It happened on the night of August 14th, 2015,” El Hattab remembers. “The children were filling jerry cans and plastic bottles from a water point that we had set up in Sa’a Square in the west of the city. A mortar shell came in from eastern Aleppo and killed 12 of them. I cried when I heard the news.”Now serving as UNICEF’s Senior Advisor for Water, Sanitation and Hygiene (WASH), El Hattab is watching the humanitarian crisis unfold in Ukraine, where, once again, water supplies are being impacted by intensive shelling and missile strikes on Ukraine’s cities and infrastructure.According to the United Nations Office for the Coordination of Humanitarian Affairs, an estimated 13 million people are currently in need of WASH assistance in Ukraine, some three million of them children.While the conflict in Ukraine is grabbing headlines, El Hattab is quick to point out that it is not the only active war zone, nor the only conflict where water infrastructure and supply are being impacted.“Water has been affected in almost every conflict-related emergency to which UNICEF has responded in the past few years,” he says, citing examples in Ethiopia, Iraq, the Syrian Arab Republic and Yemen. UNICEF launched a Water Under Fire campaign which included the publication of a three-volume report to draw attention to the issue in March 2019.Climate change is also driving a rise in the number of WASH emergencies, increasing the severity and incidence of droughts, flooding and storms. Recent examples include the severe flooding experienced in the Zambezia, Nampula and Tete provinces of Mozambique when the country was hit by storm Ana in January of 2022.The low-lying coastal district of Maganja da Costa was one of the areas affected. “When Storm Ana struck, 2511 latrines and 20 boreholes were destroyed,” says Charmaine Consul Goncalves, Mozambique head of programmes for WaterAid, an international nongovernmental organization, focused on water, sanitation and hygiene. WaterAid has since been supporting a local organization, Kukumbi, to provide safe water and sanitation in the area.As Goncalves points out, the damage to the district’s WASH capacity had significant knock-on effects, including damage to local health facilities. At the Mugeba Health Centre in Tapua, Zambezia, two water sources were flooded and damaged as were the latrines. “Staff had to provide medical care to 400 patients without clean water or sanitation,” Goncalves says.“Water has been affected in almost every [recent] conflict-related emergency.”Omar El HattabThis kind of domino effect is typical in WASH emergencies. “When the flow of water stops or water sources are contaminated, a lot of activities shut down, including the provision of health care,” says El Hattab, pointing out that it is in these circumstances that diarrhoeal diseases, including cholera, can spread.Emergency response typically begins with one focus: the delivery of safe drinking-water or the chemicals needed to make water safe. UNICEF’s response to the attack on Ukraine began in this way, and as of 17 May, the organization had ensured access to safe water for nearly 2.1 million people, including through water trucking, bottled water distribution and supporting water availability in collective centres. In addition, UNICEF had reached over 141 500 people with WASH supplies.But, as El Hattab explains, water trucking is only a stop-gap. Addressing WASH emergencies requires longer term interventions and these quickly become complex, requiring action on many fronts, notable among which, infrastructure repair.“In an important sense the water problem is an infrastructure problem,” says El Hattab, pointing to Ukraine’s cities as an example, where relentless shelling and missile strikes have devastated pumping and drainage infrastructure, including the power utilities needed to run it. “Without power you can’t pump or drain,” El Hattab explains. “Without power you can’t treat wastewater.”Working in collaboration with WASH partners, UNICEF is providing equipment and parts needed to repair damaged water systems in the Ukrainian cities of Sumy and Chernihiv and, as of late May, had supplied 11 tonnes of liquified chlorine gas to Kharkiv.Fixing infrastructure is not just complex, it requires foresight and planning. “You don’t just install infrastructure in the way you might install portacabins,” says Emmett Kearney, Senior WASH officer at the United Nations High Commission for Refugees (UNHCR). “You need to think longer term, work out what all the needs are, who has funding for what, and who can fill the gaps. You also have to prioritize within each sector and draw up a plan in consultation with the local authorities, refugees and other stakeholders. And that all has to happen early on because the decisions made in the first weeks and months of an emergency have an impact on the type of services available in five or ten years.”Margaret Montgomery, a WASH expert at the World Health Organization (WHO), agrees, emphasizing the need for collaboration in effective emergency response that includes forward planning.“The truth is we can achieve so much more by coming together in terms of technical expertise, financial resources, general dynamics and energy,” she says.It was to encourage such collaboration that, in 2005, humanitarian organizations adopted the cluster approach, to coordinate humanitarian action when a national government requests international support.Comprised of organizations working in 11 humanitarian sectors, including WASH response, clusters can include nongovernmental organizations, United Nations agencies, the Red Cross/Red Crescent Movement, and government bodies. The Global WASH Cluster (GWC) is led by UNICEF.Getting all those participants to come together in what are often high-pressure situations is challenging although examples of collaboration abound, and not just among the biggest agencies. In Mozambique, for example, WaterAid works with partners in the WASH cluster to agree the overall goals following a disaster and decide what each of them can achieve.But collaboration is not always easy. UNHCR’s Kearney lists challenges that include the differing missions and agendas of the various organizations involved.“The decisions made in the first weeks impact the type of services that will be available in five years.”Emmett KearneyBruce Gordon, Geneva-based unit head for WASH at WHO, notes the technical and institutional challenges arising from interagency, intersectoral collaboration. “Typically, WHO gets engaged if we see a threat of cholera-related or other waterborne diseases emerging. Then, what normally happens is someone says: ‘Have you talked to the WASH people?’, meaning someone in another agency such as UNICEF. It can get quite complex, which is why we are trying to do more together.”UNICEF’s El Hattab notes that there is also scope for greater local engagement in WASH response, notwithstanding the many examples where such engagement is a reality. In Ukraine, for example, UNICEF leads meetings with other WASH agencies and government authorities to agree on priorities that include integrating services for children, supporting critical services to prevent the collapse of the water supply, and holding weekly WASH meetings to assess the repairs needed to the water supply and monitor water quality.How best to encourage local governmental and/or nongovernmental agencies to get involved was a central topic of discussion at the first World Humanitarian Summit which took place in Istanbul in May 2016. To support local engagement, GWC mobilized a Field Support Team which is tasked with helping National Humanitarian WASH Coordination Platforms, which, as the name suggests, are intended to consolidate local emergency response capacity and action.National platforms are widely considered to be a good idea, but not everyone is convinced that they have the resources they need. “In many countries the national WASH coordination platforms continue to be under-funded,” says El Hattab, voicing a commonly expressed concern.Montgomery believes that one way to encourage more local engagement and buy-in would be for lead agencies to make less use of visible identification or branding. “The problem with slapping a logo on a pump or water tank is that the local community automatically sees it as the agency’s property or project from the start, undermining any hopes of local ownership, sustained operation, or building back better,” she says.Kearney sees other benefits to setting aside the trappings of institutional identity, and the thinking that can go with it. “It’s really important for actors to think first about the needs of affected populations, not their institutional priorities, to collectively agree on what actions to take and who does what,” he says. “There is plenty for everyone to do and no prospect of that changing in the foreseeable future.”


As a disease characterised by non-motor and very visible motor symptoms, Parkinson’s disease has been associated with multiple forms of stigma, while awareness about the disease globally remains low. The experience of stigma relating to Parkinson’s disease from high-income nations is well-documented, while less is known about low- and middle-income countries (LMICs). Literature on stigma and disease from Africa and the Global South has described the added complexities people face resulting from structural violence, as well as perceptions about symptoms and disease associated with supernatural beliefs, which can have significant implications for access to healthcare and support. Stigma is a recognised barrier to health-seeking behaviour and a social determinant of population health.This study draws on qualitative data collected as part of a wider ethnographic study to explore the lived experience of Parkinson’s disease in Kenya. Participants include 55 people diagnosed with Parkinson’s and 23 caregivers. The paper draws on the Health Stigma and Discrimination Framework as a tool to understand stigma as a process.Data from interviews identified the drivers and facilitators of stigma, including poor awareness of Parkinson’s, lack of clinical capacity, supernatural beliefs, stereotypes, fear of contagion and blame. Participants reported their lived realities of stigma, and experiences of stigma practices, which had significant negative health and social outcomes, including social isolation and difficulty accessing treatment. Ultimately, stigma had a negative and corrosive effect on the health and wellbeing of patients.This paper highlights the interplay of structural constraints and the negative consequences of stigma experienced by people living with Parkinson’s in Kenya. The deep understanding of stigma made possible through this ethnographic research leads us to see stigma as a process, something that is embodied and enacted. Targeted and nuanced ways of tackling stigma are suggested, including educational and awareness campaigns, training, and the development of support groups. Importantly, the paper shows that awareness of, and advocacy for the recognition of, Parkinson’s globally needs to improve. This recommendation is in line with the World Health Organization’s Technical Brief on Parkinson disease, which responds to the growing public health challenge posed by Parkinson’s. There is no awareness about it at all” A lack of awareness about Parkinson’s in Kenya was perceived to be the main driver of people’s perceptions about the condition and its symptoms. Poor awareness in the general population was facilitated by the lack of health policy surrounding Parkinson’s in Kenya at the time, and the limited clinical capacity of neurological services, which made it difficult for people to obtain a diagnosis and make sense of their symptoms , although on some occasions, it was participants’ spouses. Participants described how other people were more likely to believe in “sorcery”.‘’There’s that whole thing of whatever you don’t understand is witchcraft...‘Some spirits are behind this whole thing’... There are some people who believe there’s no such thing as illness... So, there’s no way you’re going to convince such people that this person is just sick... The most meaningful [explanation] is witchcraft’’’ Supernatural beliefs were significant drivers of stigmatising perceptions, “surely these peculiar conditions demand an explanation” (p.21), and the rational explanation was witchcraft.Evans-Pritchard  learned Why someone had been cursed was a particular driver for stigmatising perceptions – often associated with blame. Who was responsible for the individual being cursed was placed on different groups: the person with Parkinson’s, family members, ancestors, friends, the devil (Satan), and God. One caregiver described how his mother’s church group convinced her that she was being “punished” for something she had done:“Her church, they come and say, ‘This is your servant who has been faithful all these many years, why her?’ And so, they say, ‘Is it something you did?’… This idea was sort of put in her head by the rest of the church members” “must have done something wrong”, creating a form of internalised, or self-stigma. Alternative explanations included “jealousy” of the person with Parkinson’s and their successes in life.The idea of punishment put the blame on the person with Parkinson’s, implying that they “Worry, uncertainty, you know, what happened, what did we do wrong, what did she do wrong… We always have [curses] in mind, even after we knew it is Parkinson’s, there’s still that probably, maybe somebody, relatives, spoke, because we believe in those altars of witchcraft… There’s some people who can go out and curse you” In addition to the belief that curses could be placed directly on the person with Parkinson’s, several described the possibility of family curses .Again, Evans-Pritchard identified similar beliefs among the Azande , where k“[people] think they could get sick like me”, but also from the curse that was believed to have caused it.“They’re like, ‘I don’t want to go to that house because whatever spirit is there might get into me’… There’s some people I don’t expect to ever see coming to visit because they believe that my dad is bewitched and if they come anywhere near him, the same thing might happen to them” Closely linked with the idea of witchcraft was a fear of contagion from Parkinson’s, as one 58-year-old participant described, Fear of contagion is a powerful driver of stigma that has also been observed in other ‘visible’, non-communicable neurological conditions, such as epilepsy, in Nigeria  and CameFurthermore, participants reported how fluctuations in symptoms (dependent on ‘on’ and ‘off’ times) caused conflicting reports of the person’s condition, which could further contribute to the belief that supernatural forces were at play or that the person was pretending or malingering , acting“[people] just think he is old” and had respect for him because of his age. Older people were also expected to have some form of disability and deterioration as they aged, which meant that, even with Parkinson’s symptoms, this was largely perceived as “normal” old age. For a discussion on the expectations around ageing among participants, and how the progression of Parkinson’s fits within these expectations, see Fothergill-Misbah et al. Age was an intersecting stigma, with younger participants reporting more experiences of stigma than older individuals (described below). Some younger participants felt they were suffering from a disease of ‘older people’ when they should have been in their “youthful years”, being productive and “useful”. In contrast, Olivia described how she would take her 71-year-old father out in his wheelchair but said, Participants described their experiences  of stigma, which included internalised (felt or self), anticipated and secondary (associative) stigma, as well as stigma practices (enacted stigma), which could reinforce prejudices towards people with Parkinson’s, fuelling social inequalities .Participants reported multiple experiences of enacted stigma, that is, discrimination by others towards them because of their condition (stigma practices). This involved discrimination by strangers, wider family and friends, and, in some cases, immediate family members . Tuwile, a 58-year-old man with Parkinson’s, had very pronounced, outward physical symptoms, including dyskinesias  which could be shocking. He recalled people avoiding him on the street, taking a wide berth around him, crossing over the road when they saw him coming, vacating the seat if he sat next to them on the bus, and avoiding interaction with him. From Tuwile’s experience, and as discussed above, it became clear that participants who were younger and had more visible symptoms tended to experience, or report, more stigmatising perceptions than older people. Tuwile also made obvious efforts to hide his head-jerking movements, suggesting that the enacted stigma contributed to internalised or self-stigma.“disappeared into thin air”.“Most of [my friends] left me. You know, not many people want to associate with you when you have a strange condition… In fact, I had a list of about 100 friends, now I have about ten left” Other participants acknowledged how families and friends had distanced themselves from the individual with Parkinson’s and their immediate family (secondary stigma), or “somebody had cursed [him] out of envy”. He explained he had to acquiesce this belief for fear of losing her support.“Initially I had to lie low when they [immediate family] came about with those ideas because I really wanted their support, you see, so I could seem like to agree with them. But I knew inside myself that it was not spiritual… I couldn’t be in a position where I could argue with my wife because what if she goes? That would be my worst… I’m afraid if that can happen” Four younger male individuals also described instances of enacted stigma by their spouses, resulting partly from their inability to explain the origin of their symptoms, as well as their (reported) inability to continue working and providing for their families, which resulted in abandonment see  section.“Sometimes, I feel out of place. Sometimes, I feel like I am a burden”. Hermanns has referred to similar “invisible” manifestations of stigma in the USA, including concerns of being a burden  or why we are letting him work. But we’d inform them that he has to exercise his hands and exercise himself… Everyone used to ask why we are letting him work, we should let him stay home” Caregivers also described situations where progressing symptoms resulted in withdrawal from social occasions. For example, Anya’s husband had difficulty with his mobility and speech as his condition progressed, which resulted in people not being able to understand him, and him being excluded from conversations in social situations. Occasions such as this could fuel internalised stigma and contribute to individuals with Parkinson’s having to come to terms with a changing ‘self’ as well as changing roles. These perceptions could be reinforced by others’ beliefs that people with Parkinson’s should not be working or participating in particular aspects of society, contributing to a form of internalised stigma about their ability. For example, Julian’s uncle with Parkinson’s sold flowers and plants on the side of a busy road:In contrast, one participant described how her aunt had to continue working on her fruit and vegetable stall, otherwise people might think she was “pretending to be sick” so she could avoid work. Individuals had to constantly negotiate other people’s perceptions about their condition and ability.Participants also described feelings of self-stigma that resulted from their embarrassment about their symptoms, for example, spilling food, needing a walking stick, or drooling (similar to findings in The Netherlands ). SimilaThe different forms of stigma described had social outcomes, from isolation and abandonment to advocacy, and health outcomes, including barriers to seeking treatment, or use of alternative treatment. Subsequently, stigma resulted in wider health and social impacts, affecting quality of life, aggravating poverty due to loss of income, increasing the severity of disability and sometimes resulting in mortality.Stigma experiences and practices contributed to people with Parkinson’s increasingly avoiding social situations, resulting in isolation and reduced social interactions. Several participants described feelings of loneliness as a result, and worsening mental health, perpetuating self-stigma experiences. Most participants were no longer able to engage in paid work, limiting their financial capacity and increasing their reliance on others for support. This also had consequences on their physical health, with reduced opportunities for mobility and exercise, an important aspect of the management of disease, and contributed to a reduced quality of life. Stereotypes of Parkinson’s (described above) could also delay treatment and health seeking, making their outward, visible symptoms more pronounced and noticeable as the disease progressed unmanaged.“witchcraft and superstitions”, and he instead lived alone in the city.In the case of 4 younger male participants, the enacted stigma they experienced resulted in abandonment by their immediate family. Tuwile’s wife and children had left him because he could not explain his condition or diagnosis; a consequence of challenges with awareness and clinical capacity, the resulting supernatural assumptions, and his inability to stay in employed work and support his family financially. He relied on donations from his church to buy sporadic medication and afford food, which had a detrimental effect on his health. Similarly, Magnus (55-year-old) described how he could not return home to his family in rural Kenya for 7 years because they associated his condition with In addition to the social outcomes that abandonment presented, the exclusion of individuals from their families also resulted in difficulties accessing timely and appropriate healthcare services and acquiring necessary medications, contributing to significant disease progression and deterioration in health and, in Tuwile’s case, death.“mganga”, “witchdoctor” or “special priest” who could “remove their curse”. Participants described how friends and family suggested they should cease taking their biomedical medication and instead organise “special prayers” to “cast out the demons” causing their symptoms. These alternative therapies often resulted in worsening symptoms and could create tensions within the family. For example, Eunice, the spouse of a 79-year-old person with Parkinson’s, was accused by a family member of wanting her husband dead after refusing to give him ineffective and expensive herbal medicines. This demonstrates the pressure individuals and families were under to conform to expectations and certain behaviours, or risk further stigmatising perceptions and potential exclusion.Supernatural beliefs could also result in the use of alternative therapies, for example, seeing a “real disease” and raise awareness.“I wish I could get a platform to make people know that there are people like that, there’s a condition like that, and they can get help and can live a normal life like normal people… so that they could not be jilted, they could not be like, cast out” Despite the damaging health and social outcomes reported, there were some positives. Stigma can foster resilience and advocacy efforts among stigmatised groups – such as was seen with HIV . AlthougFor some participants, their involvement in support groups was a way for them to surround themselves with people going through similar situations, validating the existence of ‘Parkinson’s disease’ as a biomedical diagnosis , beliefs about the person pretending or malingering, stereotypes (such as age), and fluctuations in symptoms, i.e., on and off times. The identification of these drivers highlights opportunities to intervene in the stigma process. However, it is possible that any efforts to tackle stigma are negated by the lack of policies and practices currently in place to support individuals.Severe structural constraints facilitated the stigma process, notably, the lack of policy surrounding Parkinson’s and neurological disorders, the limited clinical capacity, poor accessibility of services and unaffordable medication, lack of financial protection from health costs, lack of social protection, and limited rights for people living with disabilities. These broader social and political processes that create widespread health and social inequalities, and create unequal distributions of power and resources, are what Galtung referred to as “structural violence” . It is dThis research has highlighted, in more detail than has been reported previously, the lived realities and outcomes of the stigma process for Parkinson’s. The lived experiences of stigma – including what literature refers to as self (or felt), enacted, anticipated and secondary stigma – impacted social relationships, impeded resource availability , hindered access to health services and medication, contributed to stress and psychological responses, social isolation, and, ultimately, resulted in poor or sub-optimal health outcomes. Participants’ reports of being avoided on the street, excluded from social circles and communities, their inability to afford food or medication, and in some cases, being abandoned by spouses, significantly affected their quality of life, aggravated poverty, and increased the severity of disability, highlighting the significant public health issue of stigma. Those with lower social and financial capital appeared more likely to succumb to the consequences of stigma, as did younger individuals (intersecting stigma). These findings resonate with Goffman’s early work on stigma, spanning all three stigma “types”: physical, behavioural and social  . HoweverThese experiences from Kenya can be situated in the context of stigma across other communicable and non-communicable conditions. Health-related stigmas share commonalities across the socioecological spectrum and exploring these comparisons can contribute to our theoretical understanding of stigma as a process . Having Parkinson’s is a visible disease, characterised by uncontrollable and involuntary body movements, i.e., tremor and dyskinesia, but also by “abnormal” behaviours as the disease progresses, e.g., hallucinations, apathy and cognitive impairment. These features of Parkinson’s have commonalities with other neurological conditions and, therefore, similarities in stigma practices and outcomes. For example, the very visible and unpredictable seizures characteristic of epilepsy, or the loss of inhibition or aggressive outbursts seen in dementia, have been reported to result in social rejection and exclusion in Africa, ultimately undermining the quality of life of individuals , 53. A sLiterature on stigma relating to neurological disease (and wider disease areas), particularly from Africa, highlights the social exclusion individuals can experience, which is often associated with fear of disease manifestations, contagion and supernatural beliefs. These associations have also been acknowledged in Tanzania, Uganda and South Africa relating to Parkinson’s, suggesting that supernatural beliefs are likely to be widespread drivers of stigma on the continent, and have some of the most significant consequences for stigmatised groups. It is important to note that participants in this study were necessarily limited to those with the social and financial resources to access care in Kenya; those who have never accessed care may have unique experiences of stigma which require further exploration.“corrosive influence on health” (p. 816) which manifests through the disruption of institutional and communal systems, interpersonal systems, and intrapsychic systems caused by the stigma ‘process’ [“fundamental cause of health inequalities” (p. 819), affecting health outcomes, preventing access to resources which could otherwise minimise poor health, while perpetuating the reproduction of health inequalities among groups.Hatzenbuehler, Phelan and Link write that stigma has a process’ . They prHaving said that, stigma can also have positive outcomes , particuStigma has been described as a driver of morbidity and mortality at a population level , and a sCross et al. produced guidelines on interventions for stigma reduction, proposing that responses should change harmful stigma-related attitudes or actions, require multidimensional considerations  and inclBased on the three strategies above, findings from research in Kenya, and the goals of existing global Parkinson’s advocacy groups, I propose 7 activities for stigma reduction  and high blood pressure (presha) in Kenya or anti-stigma campaigns for mental health . IncreaThis paper has shown, in more detail than previous studies –15, how As the incidence and prevalence of Parkinson’s continue to increase globally, awareness of the disease and advocacy for its recognition in low- and middle-income countries needs to improve. One positive step towards achieving this is the release of the Technical Brief ‘Parkinson disease: A public health approach’ by the World Health Organization , which a


Previous mental health studies have shown higher levels of anxiety, stress, and depression symptoms among university music students. In general, some similar findings have been observed for Malaysian music university students. In diagnosing the complications of mental health, there is consensus that it is essential to develop and evaluate a model oriented toward mental health illness prevention and treatment. To date, a suitable pattern for estimating mental health in terms of anxiety, stress, and depression among music university students is lacking. To fill this gap, we collected the necessary data from 691 music and 871 general students who were students for one year. The introduced pattern includes socioeconomic status, fear of COVID-19, nomophobia, sleep quality, loneliness, and mental health. Our data analysis proved that the levels of anxiety, depression, and stress of music students were lower than those of general students. Unlike some previous studies, in this study, the fear of COVID-19 and nomophobia didn’t have the most significant impact on mental health. The most significant impacts were related to sleep quality and loneliness. These findings have the potential to inform health promotion and services in the music education system. ColleAccording to the findings of the studies cited above, even before the widespread spread of the COVID-19 virus, there have been growing worries in recent years regarding the mental health of college students. Students in higher education institutions are more likely to suffer from mental health issues as a direct result of the stressors and constraints brought on by the pandemic. This may have a detrimental effect on their academic performance, social relationships, and future opportunities in the professional and personal spheres. After a year and a half of the pandemic, this suffering among university students might be significant .Previous research has taken a fragmented approach to investigating the elements that affect mental health. These studies have focused on certain aspects of mental health, such as social media , physicaWhat is the status of anxiety, depression, and stress among Malaysian music university students and general students?What are the rules of fear of COVID-19, nomophobia, sleep quality, loneliness, and SES in estimating mental health among Malaysian music and general university students?Fear has been the most prevalent psychological reaction in the populace throughout the current COVID-19 outbreak . People Nomophobia, which is the fear of not having a phone or phone contact, was previously recognised as a modern disorder . It is aOne of the world’s most widespread adult difficulties is loneliness. Those who suffer from it have a “persistent and unfavourable psychological condition characterised by a sense of emotional isolation, a sense of being alone, and a sense of estrangement from others” . The negA good night’s sleep is one of the most important factors in determining how effectively one can carry out the activities of daily living and how well one can function mentally . During The online database from the Web of Science was used to search the literature on the mental health of music university students for works published between 2000 and 2022. Both “mental health” and “music students” were used as key phrases. A built model using the Bayesian SEM method was presented. The primary terms we searched from the start were “music students”, “depression”, “anxiety”, “stress” and “structural equation modelling”. We were aiming for “Fear of COVID-19” with “nomophobia” in the second phase. We combined “student mental health” with “loneliness”, “socioeconomic” and “sleep quality” for the third phase.A quantitative cross-sectional methodology was used for this investigation. From January 2022 through July 2022, the survey was fielded. The Malaysian government issued a nationwide movement control order that effectively ended on-campus, face-to-face instruction at all levels of education from kindergarten through university. Most Malaysian college students had already taken three online courses, either in real-time or asynchronously.A minimum of 100 respondents with five or fewer latent variables, each of which must have three indications, are required.A minimum of 150 respondents with seven or fewer latent variables, each of which must have three indications, are required.300 respondents are required, with certain latent variables having no more than three indications and no more than seven latent variables.500 respondents are needed, and there are more than seven latent variables, some of which have fewer than three indications.In this article, we used a cross-sectional analysis in which the required sample size is relevant to data collection at one point in time. According to Hair et al. , the samOur research framework includes six latent variables, and the educational level is categorized into two groups. Therefore, we expected to have at least 100 respondents for every group . In total, we needed 200 respondents.There was a concerted effort made to ensure sample consistency throughout this investigation. Ethical approval from the University of Malaya Research Ethics Committee (UMREC) was obtained prior to beginning data collection (UM.TNC2/UMREC 1582). Informed consent was obtained from all respondents after an explanation of the study’s goals was provided. Respondents were emailed a Google form survey with several pre-set questions. Some of them were given out by their university course instructor. A total of 1562 responses were received from the survey. All protocols and laws were strictly adhered to while conducting the research.Questionnaires were distributed among the participants to achieve the research goals. The information on the participants was organized into a few categories based on the variables which include personal SES, Fear of COVID-19, nomophobia, loneliness, sleep quality and mental health. To describe the SES variable, we used three indicators: age group, working experience, and income per month. The age group of the participants is classified into five criteria, which are ‘less than 21 years old’, ‘between 21 to 25 years old’, ‘between 26 to 30’, ‘between 31 to 35 years’ and ‘more than 35 years old’ which coded to 1, 2, 3, 4 and 5, respectively. Respondents are asked about their duration of working experience where the responses are coded as 1 for ‘no job experienced’, 2 for ‘between 1 to 3 years’, 3 for ‘between 4 to 6 years’, 4 for ‘between 7 to 10 years’ and 5 for ‘more than 10 years’. The responses to income per month are coded as 1, 2, 3, 4 and 5 for ‘less than RM 1000’, ‘RM 1000 to RM 2000’, ‘RM 2000 to RM 3000’, ‘RM 3000 to RM 4000 and ‘over RM 4000’, respectively [RM: Ringgit Malaysia]. Subjects’ mental health was evaluated using the DASS-21 , which hFrom a mathematical and statistical modelling point of view, regression (bivariate or multivariate) ,41 and AThe ability to use latent variables, a feature of SEM that is unique in that they cannot be observed directly and are not used by other analysis techniques .The capacity to calculate and analyse the direct and indirect links between the research study’s variables .The capacity to demonstrate relationships between dependent variables suggests the estimation of multiple exogenous and endogenous variables simultaneously .We used the SEM technique in this research because it has helped researchers to understand the concept of latent variables and the interactions within the model. SEM has the following features which are an advantage when applying this technique for mental health modeling.The framework of the study is presented in At 15 universities in Malaysia, an online poll was conducted. According to Fornell and Larcker , to testNext, to test the reliability of this research, every latent variable indicator should have a factor loading value higher than 0.7.Hence, after the elimination of indicators from research data, claiming the reliability of the research must comply with another condition i.e., all latent variables should have an equal or higher than 0.5 value of the average variance extracted (AVE). The output of SEM model fitting is tabulated in In the SEM analysis, we used the structural model to recognize the substantial connection between research variables that are linked to the considered conceptual model. During the course of their education, students go through a substantial transition unlike any other, from high school to university or college . This trThe purpose of this study was to investigate the factors that influence the mental health  of music and general college students, specifically focusing on fear of COVID-19, nomophobia, sleep quality, loneliness, and socio-economic connections.The findings indicated that of the variables shown to have a significant causal association with students’ mental health, among music students, sleep quality status had the most direct negative relationship, with greater sleep quality scores being related with lower mental health (DASS scores). Silva et al.’s discovery of an independent link between mental health and sleep quality status among medical  and artsIn our research, there is a strong positive correlation between loneliness and mental health. The outcomes concurred with earlier research showing that loneliness had strong significant relationships with mental health , includiAccording to the results of our research, 78.4 percent of music students suffer from some degree of nomophobia. There were 16.3% of people with mild phobia, 53.12% with moderate, and 8.98% with severe phobia. These levels are lower than those found in previous investigations among teachers  and highSES is the fourth important characteristic that has a detrimental effect on the mental health of music students. Lower socioeconomic status was related to greater DASS scores. This conclusion is consistent with the findings of Fernandes, Biswas , who fouFear of COVID-19 is the subject of numerous studies about the mental health of university students. COVID-19 had the least significant impact on mental health status among the five predictors examined in this study. In this study, fear of COVID-19, among music students, had a lesser effect on mental health than four other predictor variables: SES, sleep quality, loneliness, and nomophobia. However, this does not imply reduced worry of COVID-19. Young university students’ fear of COVID-19 may have been strongly influenced by the quick spread of the disease, the enormous number of individuals affected, the rising number of fatalities, mistrust of the health care system, ignorance, and disinformation. This fear has been identified as a factor that affects depression, and the effects of this fear on depression may be exacerbated by the presence of anxiety. The majority of students live away from their families, are unable to return, and/or reside in poor conditions where it is difficult to remain healthy and make ends meet, causing them to experience more fear when they perceive they are in a more precarious and dangerous situation.Some studies involved “family chronic illness” and “mental wellbeing history” for analyzing anxiety, depression, and stress among university students ,68. HoweThe study’s validity may be jeopardized because the data was self-reported. Because this method has been widely used in previous studies, we are confident that the data obtained are of high quality, and our data collectors stressed the confidentiality of all answers.Nomophobia may cause someone who is afraid of COVID-19 to use a smartphone to look for online help regarding their mental health. This should be researched further.We used nomophobia in our research model. “Technostress” is a well-known indicator that has been used in previous studies related to university students’ academic performance , sleep qIt would be prudent to repeat the study during later phases of the pandemic and under normal conditions, as our study may have been a snapshot geared toward coping with COVID-19 in Malaysia’s last phases.This article describes a new study that used Bayesian SEM to examine the mental health of music university students at various educational levels. In the SEM technique, the significance of the variables is very important in measuring the strength of the relationship between variables. This would be a beneficial addition to future research to expand knowledge of mental health among music university students, which is becoming a serious issue that needs to be addressed.According to the findings of this study, music students’ perceptions of uncertainty and risk might serve as a fertile breeding ground for stress, anxiety, and depression, resulting in a mental health concern. Recognizing the complexity of the interactions between these elements and developing mental health symptoms, we must rapidly develop intervention programs in universities to assist these music and general students in better coping with this type of situation. We found that the levels of anxiety, depression, and stress of music students are lower than those of general students. This study developed a framework for music students’ mental health, which improved based on previous studies related to SES, fear of COVID-19, loneliness, nomophobia, and sleep quality. The most significant impacts among music students belonged to loneliness and sleep quality. However, among general students, the most significant impacts belong to nomophobia and SES. Nevertheless, a few limitations to this research have occurred as follows: