Search Results (31)

Background/Objectives: Currently, Oman lacks a valid culture-specific food frequency questionnaire (FFQ) for adults. This research aimed to develop and validate a reliable (FFQ) specifically for Omani adults. The study was conducted in two phases, employing both qualitative and quantitative methods. Phase 1 was the development of the (FFQ); in this phase the Diet History Questionnaire II (DHQ II) was adapted to develop the Omani Food Frequency Questionnaire (OFFQ), translated to the Arabic language, back-translated to English, pilot tested, and then refined to be used in the reliability study. Phase 2 was the reliability study, in this phase, the OFFQ was administered twice in Arabic with the second being filled one to two weeks after the first questionnaire. Methods: A convenience sample of healthy Omani adults (n = 62) was recruited from Sultan Qaboos University (SQU) employees and students. To assess the reliability of the OFFQ both internal consistency and test–retest reliability were assessed. Internal consistency was assessed by conducting Cronbach’s α test, while test–retest reliability was assessed by comparing the median intake of food groups by calculating weighted kappa (K_W) and intraclass correlation coefficients (ICCs). Results: Weighted kappa (K_W) between the two OFFQ administrations showed fair to moderate agreement with (K_W) values ranging from 0.38 to 0.60 for questions assessing the frequency of intake. While the median (K_W) values between the two OFFQ administrations ranged from 0.26 to 0.58 for questions assessing portion size. The majority of food groups showed moderate to good test–retest reliability with median (ICCs) for food groups ranging from 0.57 to 0.80 for frequency questions and from 0.40 to 0.82 for portion questions. Conclusions: In conclusion, the newly developed OFFQ was deemed valid for the Omani dietary culture and is a reliable tool that can measure habitual dietary intake among Omani adults as evidenced by the reliability coefficients ranging from moderate to good agreement for the most food items and food groups. Future studies are warranted to assess the relative validity of the OFFQ and the inclusion of diverse demographic groups and a larger sample size. Full article

This inquiry articulates a conceptually cohesive framework to explore the interplay between ethical leadership–affective commitment, particularly in settings characterized by socio-environmental volatility. Central to the analysis is the examination of how ethical climate functions as a psychological conduit and how psychological empowerment modulates this pathway. Empirical validation was carried out with a sample of 448 employees (175 women, 273 men) from Colombia’s electricity sector, a context where institutional fragility elevates the salience of ethical practices. The study employed structural equation modeling to test the model’s robustness. Results underscore that ethical leadership cultivates a benevolent ethical climate, which in turn reinforces affective commitment. Importantly, this sequence is not fixed but is contingent upon psychological empowerment. The influence of ethical leadership on ethical climate and especially on affective commitment is amplified when empowerment is high; likewise, the ethical climate–affective commitment link becomes more salient under elevated empowerment conditions. These findings highlight the influence of ethical dynamics in organizations. Beyond model validation, this research contributes to broader conversations on social sustainability. Ethical leadership is shown to foster organizational climates rooted in fairness, stakeholder sensitivity, and moral coherence—factors essential for long-term institutional legitimacy. In environments such as Colombia’s electricity industry, where governance infrastructures are evolving, such leadership emerges as a necessary condition for rebuilding trust and promoting shared ethical standards. Accordingly, this study advocates for the systematic cultivation of ethical leadership as a means to enhance organizational loyalty and public credibility. The theoretical model presented here offers fertile ground for cross-cultural replication and further inquiry across industries in emerging economies. Full article

Background/Objectives: Beef is a significant dietary component, and the concept of food quality is inherently complex and multidimensional. This study addresses this complexity within the context of beef products by examining four key attributes: price fairness, freshness, portion size, and packaging. It further investigates the structural relationships among food quality, consumer trust, and revisit intention, with particular attention to the moderating role of price fairness in the link between trust and revisit intention. Methods: Data were collected through an online survey administered via the Clickworker platform, targeting 415 U.S. consumers selected for their cultural relevance and substantial beef consumption. Structural equation modeling using maximum likelihood estimation was employed to test the hypotheses, and Hayes’ process model 15 was applied to assess the moderating effects. Results: The results show that consumer trust is positively influenced by all four quality attributes, and that freshness, portion size, packaging, and trust are positively associated with revisit and repurchase intentions. Moreover, price fairness demonstrated a significant moderating effect, framed within the heuristic decision-making perspective. Conclusions: This study contributes to the literature by shedding light on the determinants of consumer trust and repeat purchasing behavior in beef consumption. It underscores the heuristic role of price fairness and the interplay between perceived quality attributes and trust, offering practical insights for businesses seeking to enhance consumer perception and foster brand loyalty. However, this work is limited to the selection of the sample. Full article

Background/Objectives: Mental health conditions represent a growing global health concern, disproportionately impacting populations in low- and middle-income countries like Pakistan. Limited epidemiological data, coupled with recent socioeconomic and environmental disruptions, has intensified the need for current insights into psychological burden and coping capacities in the Pakistani population. Methods: A descriptive, cross-sectional survey was conducted from January to May 2023 among 400 community-dwelling adults attending outpatient departments in Islamabad and Rawalpindi. A structured 75-item questionnaire incorporating validated tools (PHQ-9, GAD-7, WHO-5, CSES, and SRQ-20) was used to assess depression, anxiety, well-being, coping self-efficacy, and mental distress. Descriptive statistics, χ² and Fisher’s exact tests, and Spearman’s rank correlation (r_s) analyses were performed using IBM SPSS 22.0. Results: Most respondents were male (73.0%), aged 25–34 (60.0%), and urban-dwelling (80.0%). Clinically relevant depression and anxiety were observed in 57.0% and 19.5% of participants, respectively; 38.0% reported mental distress. Conversely, 76.5% demonstrated fair-to-good coping efficacy and 51.0% had high well-being scores. Younger age (≤34 years), higher income, urban residence, and male gender were associated with significantly better mental health outcomes. Strong positive correlation was found between PHQ-9 and GAD-7 scores (r_s = 0.672), and moderate negative correlations were found between GAD-7 and WHO-5 (r_s = −0.496), and PHQ-9 and WHO-5 (r_s = −0.310). Conclusions: Our findings highlight the significant psychological burden among urban Pakistani adults, alongside promising levels of resilience and coping self-efficacy. These results emphasize the urgent need for early, culturally adapted mental health screening and intervention programs in outpatient settings. Integrating such strategies into primary care, particularly for vulnerable subgroups like women, older adults, and those with lower income could facilitate timely diagnosis, improve outcomes, and reduce stigma surrounding mental health. Full article

Introduction: Previous neuroimaging studies have reported structural brain alterations and local network hyperexcitability in terms of increased slow-wave electroencephalography (EEG) activity in patients with borderline personality disorder (BPD). In particular, intermittent rhythmic delta and theta activity (IRDA/IRTA) has drawn attention in mental health contexts due to its links with metabolic imbalances, neuronal stress, and emotional dysregulation—processes that are highly pertinent to BPD. These functional disturbances may be reflected in corresponding structural brain changes. The current study investigated cortical thickness and subcortical volumes in BPD and examined their associations with IRDA/IRTA events per minute, symptom severity, and neuropsychological measures. Methods: Seventy female BPD patients and 36 age-matched female healthy controls (HC) were included (for clinical EEG comparisons even 72 patients were available). IRDA/IRTA rates were assessed using an automatic independent component analyses (ICA) approach. T1-weighted MRI data were obtained using a MAGNETOM Prisma 3T system and analyzed with FreeSurfer (version 7.2) for subcortical structures and CAT12 for cortical thickness and global volume measurements. Psychometric assessments included questionnaires such as Borderline Symptom List (BSL-23) and Inventory of Personality Organization (IPO). Neuropsychological performance was evaluated with the Test for Attentional Performance (TAP), Culture Fair Intelligence Test (CFT-20-R), and Verbal Learning and Memory Test (VLMT). Results: Between-group comparisons exhibited no significant increase in IRDA/IRTA rates or structural abnormalities between the BPD and HC group. However, within the BPD group, cortical thickness of the right isthmus of the cingulate gyrus negatively correlated with the IRDA/IRTA difference (after minus before hyperventilation, HV; p < 0.001). Furthermore, BPD symptom severity (BSL-23) and IPO scores positively correlated with the thickness of the right rostral anterior cingulate cortex (p < 0.001), and IPO scores were associated with the thickness of the right temporal pole (p < 0.001). Intrinsic alertness (TAP) significantly correlated with relative cerebellar volume (p = 0.01). Discussion: While no group-level structural abnormalities were observed, correlations between EEG slowing, BPD symptom severity, and alertness with cortical thickness and/or subcortical volumes suggest a potential role of the anterior cingulate cortex, temporal pole, and cerebellum in emotion regulation and cognitive functioning in BPD. Future research employing multimodal EEG-MRI approaches may provide deeper insights into the neural mechanisms underlying BPD and guide personalized therapeutic strategies. Full article

Background: Consistent evaluation methods foster fairness, reduce bias, and enhance student understanding and motivation. Notably, mathematical inconsistencies, such as improper weighting, flawed averaging, and unsound scaling, can undermine the accuracy and reliability of assigned grades. This paper addresses the critical need for consistent student evaluation methods, with a primary focus on ensuring mathematical consistency within grading systems. Methods: We propose a scheme aimed at identifying inconsistencies in student evaluation related to the mathematical framework of the used grading method. To explain the functioning of our construct, we provide mathematical representation of conventional grading methods, including summative assessments, rubrics, and the Systematic Task-Based Assessment Method (STBAM) that we have recently developed, which incorporates both traditional and fuzzy logic-based grading modules. We introduce a Consistency Index $\left({CI}_M\right)$ depending on the Mean Absolute Deviation of assigned scores ${(MAD}_M)$ and a method’s Complexity Pointer ${(CP}_M$). We also propose a method’s Efficiency Index ${(\beta }_M)$ expressed in terms of the Consistency Index and the latter indicator. We compared the mathematical consistency and efficiency of the methods addressed in this study through simulation runs. Results: We demonstrated how the proposed indices can reveal the strengths and weaknesses of each grading scheme analysed. Conclusions: The fuzzy logic-based modulus of the STBAM yielded the highest values of ${CI}_M$ and ${\beta }_M$. However, performing a pending analysis of scalability, teacher training, and cultural adaptability would be essential to strengthen the potential of the STBAM to be adopted as a reliable grading alternative to conventional grading approaches. In the meantime, our approach could provide a clear, logical, and defensible framework for testing the mathematical consistency of student assessment methods. Full article

The complexity of decision making about cultural heritage has drawn attention to hybrid and innovative models to support the challenge of its enhancement. In this context, public–private partnership (PPP) has emerged as a promising tool to address the public administration’s lack of financial resources. However, several barriers have hindered the wide application of PPPs to support heritage enhancement initiatives, thus highlighting the need to provide decision-making processes with appropriate methodological tools, especially in contexts such as UNESCO sites, where heritage conservation rises to a global challenge. Based on these premises, the paper proposes a methodological approach to support decision making about implementing PPPs for heritage enhancement in UNESCO sites by evaluating the financial sustainability of different PPP scenarios, while considering their ability to ensure a fair distribution of benefits between the public and the private. After providing a comprehensive picture of the relationship between PPPs and UNESCO sites in Italy, such an approach was tested on a case study, the “I Sassi di Matera” site that, over the last decades, has made PPPs a central tool for its enhancement strategy. The test results reveal the opportunities of the proposed approach to inform decision making and delve into PPP’s potential for heritage enhancement while outlining the related future research perspectives to ensure its broad scalability to other UNESCO contexts. Full article

Background: Person-centredness, a global movement in healthcare, is consistent with international developments in healthcare policy. It is important to have instruments to measure person-centred care. The Person-Centred Practice Inventory-Staff (PCPI-S) is an internationally recognized instrument that aims to measure how healthcare staff experience person-centred practice. Aim: To perform the cultural adaptation and psychometric testing of a Spanish version of the PCPI-S (PCPI-S (Sp)). Method: A two-stage research design was implemented as follows: (1) the translation and cultural adaptation of the PCPI-S from English to Spanish using the “Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice”; (2) a quantitative cross-sectional survey for the psychometric evaluation of the PCPI-S. Test–retest reliability was evaluated using the Kendall tau concordance coefficient, internal reliability was assessed through the ordinal theta (OT) coefficient, and confirmatory factor analysis was performed to examine the theoretical measurement model. Results: A Spanish version of the PCPI-S was obtained. There were no significant difficulties in the translation process or the consulting sessions. A sample of 287 healthcare professionals participated in the study at least once. All the items showed at least a fair level of test–retest reliability. The OT scores were adequate (>0.69). The model showed good to adequate levels of fit: CFI = 0.89, SRMR = 0.068; RMSEA = 0.060 with CI90% (0.056–0.063). Conclusions: The Spanish translation of the PCPI-S was psychometrically valid when tested with Spanish healthcare professionals. This instrument will help identify professionals’ perceptions of person-centred practice, track the evolution of this practice over time, and assess interventions aimed at improving person-centred practice. Full article

Background/Objectives: Restorative responses to staff involved in incidents are becoming recognized as a rigorous and constructive alternative to retributive forms of ‘just culture’. However, actually achieving restoration in mostly retributive working environments can be quite difficult. The conditions for the fair and successful application of restorative practices have not yet been established. In this article, we explore possible commonalities in the conditions for success across multiple cases and industries. Methods: In an exploratory review we analysed published and unpublished cases to discover enabling conditions. Results: We found eight enabling conditions—leadership response, leadership expectations, perspective of leadership, ‘tough on content, soft on relationships’, public and media attention, regulatory or judicial attention to the incident, second victim acknowledgement, and possible full-disclosure setting—whose absence or presence either hampered or fostered a restorative response. Conclusions: The enabling conditions seemed to coagulate around leadership qualities, media and judicial attention resulting in leadership apprehension or unease linked to their political room for maneuver in the wake of an incident, and the engagement of the ‘second victim’. These three categories can possibly form a frame within which the application of restorative justice can have a sustainable effect. Follow-up research is needed to test this hypothesis. Full article

Background: Air pollution has emerged as a global public health concern. Specifically, in Medellín, Colombia, episodes of elevated air pollution have been documented. Medical students’ knowledge of air pollution is paramount for implementing future interventions directed toward patients. The aim of this research was to delineate the knowledge, attitudes, and practices regarding air pollution among medical students at a private university in Medellín. Methods: A cross-sectional study involving 352 medical students was conducted. A questionnaire was administered, generating scores ranging from 0 to 100, where a higher score signified better knowledge, attitudes, and practices. Data were analyzed using frequencies, summary measures, non-parametric tests, and linear regression. Results: In total, 31% rated the education received at the university on the relationship between health and air quality as fair to poor, and 81% perceived the air quality in the city as poor. The knowledge score was 77.8 (IQR 71.1–85.6), with 90% acknowledging that exposure to air pollution increases the risk of various diseases. The attitudes score was 82.1 (IQR 71.8–87.2), and 25.9% believed that air pollution is a multifactorial problem, rendering their actions ineffective. In terms of practices, the score was 50 (IQR 42.9–57.1), indicating that students either did not employ protective measures against pollution or used inappropriate practices such as masks or air purifiers. Regression analysis revealed no association between knowledge and practices. Conclusion: The findings of this study underscore that medical students possess commendable knowledge regarding the health effects of air pollution. However, their adoption of inappropriate practices for self-protection is evident. The lack of correlation between knowledge and practices highlights the necessity of educational initiatives to be complemented by regulatory and cultural interventions. Full article

The rise in cyanobacterial blooms due to eutrophication and climate change has increased cyanotoxin presence in water. Most current water treatment plants do not effectively remove these toxins, posing a potential risk to public health. This study introduces a water treatment approach using nanostructured beads containing magnetic nanoparticles (MNPs) for easy removal from liquid suspension, coated with different adsorbent materials to eliminate cyanotoxins. Thirteen particle types were produced using activated carbon, CMK-3 mesoporous carbon, graphene, chitosan, 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)-oxidised cellulose nanofibers (TOCNF), esterified pectin, and calcined lignin as an adsorbent component. The particles’ effectiveness for detoxification of microcystin-LR (MC-LR), cylindrospermopsin (CYN), and anatoxin-A (ATX-A) was assessed in an aqueous solution. Two particle compositions presented the best adsorption characteristics for the most common cyanotoxins. In the conditions tested, mesoporous carbon nanostructured particles, P1-CMK3, provide good removal of MC-LR and Merck-activated carbon nanostructured particles, P9-MAC, can remove ATX-A and CYN with high and fair efficacy, respectively. Additionally, in vitro toxicity of water treated with each particle type was evaluated in cultured cell lines, revealing no alteration of viability in human renal, neuronal, hepatic, and intestinal cells. Although further research is needed to fully characterise this new water treatment approach, it appears to be a safe, practical, and effective method for eliminating cyanotoxins from water. Full article

The purpose of the present study was to carry out a systematic review and a meta-analysis determining the effects of sports game intervention on fundamental motor skills in children. This paper presented a systematic review from 2001 to 2020, including the databases of Web of Science, EBSCO, Science, PubMed and Springer. (1) Participants comprised 1701 children age 3–12 years; (2) sports game interventions were investigated; (3) only studies using a Test of Gross Motor Skills assessment were included; (4) RCT were chosen as the study design to assess the impact of sports game interventions on children’s motor skills; (5) only culture-based sports game studies in the English and Chinese language were included. Two researchers independently reviewed and assessed the eligibility criteria. Out of the initial 1826 references, 12 studies with a total of 1608 participants were included in the meta-analysis. All interventions were implemented in preschool (kindergarten) or primary school populations, and all studies followed a randomized controlled trial design. The results demonstrated significantly superior development of fundamental motor skills in the intervention groups compared to the control groups (standardized mean difference = 0.30, p < 0.0001). The methodological quality of the included studies ranged from fair to excellent, and no evidence of publication bias was observed. Among them, the 12-week sports game intervention of 35 min each time three to four times a week had a better intervention effect, promoting children’s physical health and fundamental motor skills. Full article

Background: The purpose of nutrient profiling models (NPM) is to evaluate and categorize food products, in order to make it easier for consumers to choose healthier options, to encourage the development of nutritious foods, and to restrict the excessive advertising of products with poor nutritional value. In Thailand, a front-of-package nutrition labeling scheme (FOPNL), known as the “Healthier Choice” symbol (HCL), has been adopted. For composite meal products, the HCL uses a nutrient profiling model (HCL–NPM) to determine which product qualifies as ‘healthier’ and is allowed to display the HCL symbol. This research aims to assess the convergent validity of this scoring algorithm. Methods: A secondary data analysis, using the Mintel Global New Products Database, was conducted. The nutrient composition of newly launched composite meals marketed in Thailand from 2016 to 2021 was included. An analysis of convergent validity was conducted using the following tests: (1) the Pearson correlation test with the Nutri-Score Nutrient Profiling Model (NS–NPM), Health Star Rating Nutrient Profiling Model (HSR–NPM), and Nutrient-Rich Food Index 6.3 (NRF6.3); (2) the Cohen’s kappa coefficient agreement analysis, to identify ‘healthier’ products with the Nutri-Score FOPNL (NS–FOPNL), Health Star Rating FOPNL (HSR–FOPNL), Chilean Warning Label (CWL–FOPNL), and Choices International (CI–FOPNL). Results: A total of 589 composite meal products were included. The median score of HCL–NPM was 18.0 points (with an interquartile range of 14.0–22.0), and the mean +/− standard deviation score was 18.3+/−5.4 points. The Pearson’s correlation coefficient revealed that the HCL–NPM had a moderate negative correlation with the NS–NPM (r = −0.458; 95%CI: −0.520 to −0.391) and with HSR–NPM (r = −0.524; 95%CI: −0.520 to −0.391), while a weak positive correlation was found with NRF6.3 (r = 0.369; 95%CI: 0.297 to 0.436). In the agreement analysis, HCL–FOPNL had a fair pair-wise agreement with CI–FOPNL (κ = 0.335; 95%CI: 0.218 to 0.453), whereas a slight agreement was reported when compared to CWL–FOPNL (κ = 0.187; 95%CI: 0.145 to 0.228), NS–FOPNL (κ = 0.172; 95%CI: 0.132 to 0.211), and HSR–FOPNL (κ = 0.157; 95%CI: 120 to 0.193). Conclusion: The HCL algorithm system could be used to evaluate culture-specific packaged composite meal products in Thailand. It exhibits sufficient correlation and agreement with other international FOPNLs. These results may be helpful in informing improvements to the “Healthier Choice” scheme in Thailand. Full article

A fundamental concept in psychological and intelligence testing involves the assumption of comparability in which performance on a test is compared to a normative standard derived from prior testing on individuals who are comparable to the examinee. When evaluating cognitive abilities, the primary variable used for establishing comparability and, in turn, validity is age, given that intellectual abilities develop largely as a function of general physical growth and neuromaturation. When an individual has been raised only in the language of the test, language development is effectively controlled by age. For example, when measuring vocabulary, a 12-year-old will be compared only to other 12-year-olds, all of whom have been learning the language of the test for approximately 12 years—hence, they remain comparable. The same cannot be said when measuring the same or other abilities in a 12-year-old who has been raised only in a different language or raised partly with a different language and partly with the language of the test. In such cases, a 12-year-old may have been learning the language of the test at some point shortly after birth, or they might have just begun learning the language a week ago. Their respective development in the language of the test thus varies considerably, and it can no longer be assumed that they are comparable in this respect to others simply because they are of the same age. Psychologists noted early on that language differences could affect test performance, but it was viewed mostly as an issue regarding basic comprehension. Early efforts were made to address this issue, which typically involved simplification of the instructions or reliance on mostly nonverbal methods of administration and measurement. Other procedures that followed included working around language via test modifications or alterations (e.g., use of an interpreter), testing in the dominant language, or use of tests translated into other languages. None of these approaches, however, have succeeded in establishing validity and fairness in the testing of multilinguals, primarily because they fail to recognize that language difference is not the same as language development, much like cultural difference is not the same as acquisition of acculturative knowledge. Current research demonstrates that the test performance of multilinguals is moderated primarily by the amount of exposure to and development in the language of the test. Moreover, language development, specifically receptive vocabulary, accounts for more variance in test performance than age or any other variable. There is further evidence that when the influence of differential language development is examined and controlled, historical attributions to race-based performance disappear. Advances in fairness in the testing of multilinguals rest on true peer comparisons that control for differences in language development within and among multilinguals. The BESA and the Ortiz PVAT are the only two examples where norms have been created that control for both age and degree of development in the language(s) of the test. Together, they provide a blueprint for future tests and test construction wherein the creation of true peer norms is possible and, when done correctly, exhibits significant influence in equalizing test performance across diverse groups, irrespective of racial/ethnic background or language development. Current research demonstrates convincingly that with deliberate and careful attention to differences that exist, not only between monolinguals and multilinguals of the same age but also among multilinguals themselves, tests can be developed to support claims of validity and fairness for use with individuals who were in fact not raised exclusively in the language or the culture of the test. Full article

In line with United Nations Sustainable Development Goal (SDG) 4.2, South Africa’s National Development Plan commits to providing high-quality early childhood education to all children by 2030 to drive improved child outcomes. Prior to 2016, South Africa lacked reliable, locally standardised, valid, and cross-culturally fair assessment tools for measuring preschool quality and child outcomes, suitable for use at scale within a resource-constrained context. In this paper we detail the development and evolution of a suite of early learning measurement (ELOM) tools designed to address this measurement gap. The development process included reviews of literature and other relevant assessment tools; a review of local curriculum standards and expected child outcomes; extensive consultation with government officials, child development experts, and early learning practitioners, iterative user testing; and assessment of linguistic, cultural, functional, and metric equivalence across all 11 official South African languages. To support use of the ELOM tools at scale, and by users with varying levels of research expertise, administration is digitised and embedded within an end-to-end data value chain. ELOM data collected since 2016 quantify the striking socio-economic gradient in early childhood development in South Africa, demonstrate the relationship between physical stunting, socio-emotional functioning and learning outcomes, and provide evidence of the positive impact of high-quality early learning programmes on preschool child outcomes. To promote secondary analyses, data from multiple studies are regularly collated into a shared dataset, which is made open access via an online data portal. We describe the services and support that make up the ELOM data value chain, noting several key challenges and enablers of data-driven change within this context. These include deep technical expertise within a multidisciplinary and collaborative team, patient and flexible capital from mission-aligned investors, a fit-for-purpose institutional home, the appropriate use of technology, a user-centred approach to development and testing, sensitivity to children’s diverse linguistic and socio-economic circumstances, careful consideration of requirements for scale, appropriate training and support for a non-professional assessor base, and a commitment to ongoing learning and continuous enhancement. Practical examples are provided of ways in which the ELOM tools and data are used for programme monitoring and enhancement purposes, to evaluate the relative effectiveness of early learning interventions, to motivate for greater budget and inform more effective resource allocation, to support the development of enabling Government systems, and to track progress towards the attainment of national and global development goals. We share lessons learnt during the development of the tools and discuss the factors that have driven their uptake in South Africa. Full article