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This pilot study aims to examine the prevalence of test anxiety and its interplay with attitudes, confidence, efficacy, academic performance and socio-demographic factors within the domain of science, technology, engineering and mathematics (STEM) courses.

The authors employed a quantitative, cross-sectional design with 549 sixth-grade students from public lower secondary schools in Prishtina, Kosovo, using the Student Attitudes Toward STEM Survey (S-STEM) for middle/high schools and the test anxiety questionnaire.

Over 70% of Kosovo's sixth-grade students reported moderate to severe test anxiety. The age of students was found to be inversely related to academic performance in STEM. The father's employment was associated with favorable STEM attitudes, confidence, efficacy and academic performance. Having a personal study environment was connected with favorable STEM attitudes, confidence and efficacy in STEM, whereas access to technology was associated with positive academic performance. Test anxiety, academic performance and personal study space predicted students' attitudes, confidence and efficacy in STEM and 21st-century learning.

Educational institutions should prioritize student well-being. By addressing test anxiety, these institutions can create supportive learning environments that improve attitudes, confidence and efficacy in STEM fields. These efforts are crucial for STEM career development and student success in the 21st-century workforce.

The current study findings contribute to a deeper understanding of the factors influencing STEM student engagement and performance, highlighting the importance of addressing test anxiety for positive learning outcomes while emphasizing the need to consider socio-economic and contextual factors in education.

The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.