Search results for: nordic questionnaire

Authors: Cornelius Femi Popoola

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Nigerian manufacturing industry, particularly the flour producing firms play vital roles in Nigerian economy. This sector’s quality management practice is given a little attention along with organizational factors that hinder successful practice of total quality management which needs to be documented. Honeywell Flour Mills Plc operate in Nigeria with an appreciable number of products that serves this sector of the economy. Internal-external disposition of the company and total quality practice of the company deserve some elucidations. Hence, this study examined the influence of organizational factors on total quality management practice of Nigerian manufacturing industry, using Honeywell Flour Mills Plc as a case study. The study employed the correlational type of descriptive survey research design. The population consisted of 656 staff of Honeywell Flour Mills Plc, out of which 235 members were selected through scientific sampling method developed by Paler-Calmorin and Calmorin. A total of 235 copies of questionnaires titled 'Organisational Factors and Total Quality Management Practices (QF-TQM) Questionnaire' were administered with a response rate of 66 copies returned. The following variables were applied internal organisational factors (IOFs), external organizational factors (EOFs) and total quality management (TQM). Data generated were analysed using frequency distribution and regression analysis at 0.05 level. The findings revealed that IOFs positively and significantly related with TQM (r = .147**, N= 64, P(.000) < .01). Also, EOFs negatively and significantly related with TQM (r = -.117, N= 64, P(.000) < .01). Findings showed that internal and external organizational factors jointly influenced TQM practiced in F₍₂,₆₁₎=22.250; R²=.629; Adj.R²=.603; P(.000) < .05). The study concluded that organizational factors are determinants of TQM practice in Nigerian manufacturing industry. It is recommended that both internal and external organizational factors influencing TQM practices should be considered in the development of TQM strategies.

Keywords: external organizational factors, internal organisational factors, Nigerian manufacturing industry, total quality management

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Authors: Taimaz Larimian, Negin Sadeghi

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Very little is known about the impacts of urban security on the level of social sustainability within the cities of developing countries. Urban security is still struggling to find its position in the social sustainability agenda, despite the significant role of safety and security on different aspects of peoples’ lives. This paper argues that urban safety and security should be better integrated within the social sustainability framework. With this aim, this study investigates the hypothesized relationship between social sustainability and Crime Prevention through Environmental Design (CPTED) approach at the neighborhood scale. This study proposes a model of key influential dimensions of CPTED analyzed into localized factors and sub-factors. These factors are then prioritized using pairwise comparison logic and fuzzy group Analytic Hierarchy Process (AHP) method in order to determine the relative importance of each factor on achieving social sustainability. The proposed model then investigates social sustainability in six case study neighborhoods of Isfahan city based on residents’ perceptions of safety within their neighborhood. Mixed method of data collection is used by using a self-administered questionnaire to explore the residents’ perceptions of social sustainability in their area of residency followed by an on-site observation to measure the CPTED construct. In all, 150 respondents from selected neighborhoods were involved in this research. The model indicates that CPTED approach has a significant direct influence on increasing social sustainability in neighborhood scale. According to the findings, among different dimensions of CPTED, ‘activity support’ and ‘image/ management’ have the most influence on people’s feeling of safety within studied areas. This model represents a useful designing tool in achieving urban safety and security during the development of more socially sustainable and user-friendly urban areas.

Keywords: crime prevention through environmental design (CPTED), developing countries, fuzzy analytic hierarchy process (FAHP), social sustainability

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Authors: V. Suganya, V. Balasuriya

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The functioning of Micro and Small Scale (MSS) businesses in the northern part of Sri Lanka was vulnerable due to three decades of internal conflict and the subsequent post-war economic openings has resulted new market prospects for MSS businesses. MSS businesses survive and operate with limited resources and struggle to access finance, raw material, markets, and technology. This study attempts to identify the manner in which entrepreneurial orientation puts into practice by the business operators to overcome these business challenges. Business operators in the traditional food processing sector are taken for this study as this sub-sector of the food industry is developing at a rapid pace. A review of the literature was done to recognize the concepts of entrepreneurial orientation, defining MMS businesses and the manner in which business performance is measured. Direct interview method supported by a structured questionnaire is used to collect data from 80 respondents; based on a fixed interval random sampling technique. This study reveals that more than half of the business operators have opted to commence their business ventures as a result of identifying a market opportunity. 41 per cent of the business operators are highly entrepreneurial oriented in a scale of 1 to 5. Entrepreneurial orientation shows significant relationship and strongly correlated with business performance. Pro-activeness, innovativeness and competitive aggressiveness shows a significant relationship with business performance while risk taking is negative and autonomy is not significantly related to business performance. It is evident that entrepreneurial oriented business practices contribute to better business performance even though 70 per cent prefer the ideas/views of the support agencies than the stakeholders when making business decisions. It is recommended that appropriate training should be introduced to develop entrepreneurial skills focusing to improve business networks so that new business opportunities and innovative business practices are identified.

Keywords: Micro and Small Scale (MMS) businesses, entrepreneurial orientation (EO), food processing, business operators

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Authors: T. Aragaw, P. Gari

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In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Xiao-Yan Li, Takashi Hashimoto, Guanhong Li, Shuo Yang

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In Japanese, onomatopoeia is an important element in the lively expression of feelings and experiences. It is very difficult for students of Japanese to acquire onomatopoeia, especially, its nuances. In this paper, based on traditional L2 learning theories, we propose a new method to improve the efficiency of teaching the nuances – both explicit and tacit - to non-native speakers of Japanese. The method for teaching the tacit nuances of onomatopoeia consists of three elements. First is to teach the formal rules representing the explicit nuances of onomatopoeic words. Second is to have the students create new onomatopoeic words by utilizing those formal rules. The last element is to provide feedback by evaluating the onomatopoeias created. Our previous study used five-grade relative estimation. However students were confused about the five-grade system, because they could not understand the evaluation criteria only based on a figure. In this new system, then, we built an evaluation database through native speakers’ narrative interpretation. We asked Japanese native speakers to describe their awareness of the nuances of onomatopoeia in writing. Then they voted on site and defined priorities for showing to learners on the system. To verify the effectiveness of the proposed method and the learning system, we conducted a preliminary experiment involving two groups of subjects. While Group A got feedback about the appropriateness of their onomatopoeic constructions from the native speakers’ narrative interpretation, Group B got feedback just in the form of the five-grade relative estimation. A questionnaire survey administered to all of the learners clarified our learning system availability and also identified areas that should be improved. Repetitive learning of word-formation rules, creating new onomatopoeias and gaining new awareness from narrative interpretation is the total process used to teach the explicit and tacit nuances of onomatopoeia.

Keywords: onomatopoeia, tacit nuance, narrative interpretation, e-learning system, second language teaching

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Authors: Babawale Akin Adeyemi, Esan Temitayo, Adeyemi Olabisi Omowumi

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The paper analyzed waste disposal system in Akure, Ondo State using GIS techniques. Specifically, the study identified the spatial distribution of collection points and existing dumpsite; evaluated the accessibility of waste collection points and their proximity to each other with the view of enhancing better performance of the waste disposal system. Data for the study were obtained from both primary and secondary sources. Primary data were obtained through the administration of questionnaire. From field survey, 35 collection points were identified in the study area. 10 questionnaires were administered around each collection point making a total of 350 questionnaires for the study. Also, co-ordinates of each collection point were captured using a hand-held Global Positioning System (GPS) receiver which was used to analyze the spatial distribution of collection points. Secondary data used include administrative map collected from Akure South Local Government Secretariat. Data collected was analyzed using the GIS analytical tools which is neighborhood function. The result revealed that collection points were found in all parts of Akure with the highest concentration around the central business district. The study also showed that 80% of the collection points enjoyed efficient waste service while the remaining 20% does not. The study further revealed that most collection points in the core of the city were in close proximity to each other. In conclusion, the paper revealed the capability of Geographic Information System (GIS) as a technique in management of waste collection and disposal technique. The application of Geographic Information System (GIS) in the evaluation of the solid waste management in Akure is highly invaluable for the state waste management board which could also be beneficial to other states in developing a modern day solid waste management system. Further study on solid waste management is also recommended especially for updating of information on both spatial and non-spatial data.

Keywords: assessment, geospatial, system, waste disposal

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Authors: Kakhaber Djakeli

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For market leadership, iconic brands already start to establish their unique digital avatars into Metaverse and offer Non Fungible Tokens to their fans. Metaverse can be defined as an evolutionary step of Internet development. So if companies and brands use the internet, logically, they can find new solutions for them and their customers in Metaverse. Marketing and Management today must learn how to combine physical world activities with those either entitled as digital, virtual, and immersive. A “Phygital” Solution uniting physical and digital competitive activities of the company covering the questions about how to use virtual worlds for Brand Development and Non Fungible Tokens for more attractiveness soon will be most relevant question for Branding. Thinking comprehensively, we can entitle this type of branding as an Immersive one. As we see, the Immersive Brands give customers more mesmerizing feelings than traditional ones. Accordingly, the Branding can be divided by the company in its own understanding into two models: traditional and immersive. Immersive Branding being more directed to Sensorial challenges of Humans will be big job for International Universities in near future because they target the Generation - Z. To try to help those International Universities opening the door to the mesmerizing, immersive branding, the Marketing Research have been undertaken. The main goal of the study was to establish the model for Immersive Branding at International Universities and answer on many questions what logically arises in university life. The type of Delphi Surveys entitled as an Expert Studies was undertaken for one great mission, to help International Universities to open the opportunities to Phygital activities with reliable knowledge with Model of Immersive Branding. The Questionnaire sent to Experts of Education were covering professional type of questions from education to segmentation of customers, branding, attitude to students, and knowledge to Immersive Marketing. The research results being very interesting and encouraging enough to make author to establish the New Model of Immersive Experiential Branding for International Universities.

Keywords: branding, immersive marketing, students, university

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Authors: Cajethan U. Ugwuoke

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Agriculture is taught in secondary schools to develop skills in students which will empower them to contribute to national economic development. Unfortunately, our educational system emphasizes the application of conventional teaching methods in delivering instructions, which fails to produce students competent enough to carry out agricultural production. This study was therefore aimed at examining the application of digital technologies as tools for transformative instructional delivery. Four specific purposes, research questions and hypotheses guided the study. The study adopted a descriptive survey research design where 80 subjects representing 64 teachers of agriculture and 16 principals in the Udenu local government area of Enugu State, Nigeria, participated in the study. A structured questionnaire was used to collect data. The assumption of normality was ascertained by subjecting the data collected to a normality test. Data collected were later subjected to mean, Pearson product-moment correlation, ANOVA and t-test to answer the research questions and test the hypotheses at a 5% significant level. The result shows that the application of digital technologies helps to reduce learners’ boredom (3.52.75), improves learners’ performance (3.63.51), and is used as a visual aid for learners (3.56.61), among others. There was a positive, strong and significant relationship between the application of digital technologies and effective instructional delivery (+.895, p=.001<.05, F=17.73), competency of teachers to the application of digital technologies and effective instructional delivery (+998, p=.001<0.5, F=16263.45), and frequency of the application of digital technologies and effective instructional delivery (+.999, p=.001<.05, F=31436.14). There was no evidence of autocorrelation and multicollinearity in the regression models between the application of digital technologies and effective instructional delivery (2.03, Tolerance=1.00, VIF=1.00), competency of teachers in the application of digital technologies and effective instructional delivery (2.38, Tolerance=1.00, VIF=1.00) and frequency of the application of digital technologies and effective instructional delivery (2.00, Tolerance=1.00, VIF=1.00). Digital technologies should be therefore applied in teaching to facilitate effective instructional delivery in agriculture.

Keywords: agricultural science, digital technologies, instructional delivery, learning

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Authors: M. Sazali Said, Rahim Jamian, Shahrizan Yusoff, Shahruzaman Sulaiman, Jum'Azulhisham Abdul Shukor

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This case study focuses on the role of Universiti Kuala Lumpur Malaysian Spanish Institute (UniKL MSI) to produce technologist in order to reduce the shortage of skilled workers especially in the automotive industry. The purpose of the study therefore seeks to examine the effectiveness of Technical Education and Vocational Training (TEVT) curriculum of UniKL MSI to produce graduates that could immediately be productively employed by the automotive industry. The approach used in this study is through performance evaluation of students attending the Industrial Training Attachment (INTRA). The sample of study comprises of 37 students, 16 university supervisors and 26 industrial supervisors. The research methodology involves the use of quantitative and qualitative methods of data collections through the triangulation approach. The quantitative data was gathered from the students, university supervisors and industrial supervisors through the use of questionnaire. Meanwhile, the qualitative data was obtained from the students and university supervisors through the use of interview and observation. Both types of data have been processed and analyzed in order to summarize the results in terms of frequency and percentage by using a computerized spread sheet. The result shows that industrial supervisors were satisfied with the students’ performance. Meanwhile, university supervisors rated moderate effectiveness of the UniKL MSI curriculum in producing graduates with appropriate skills and in meeting the industrial needs. During the period of study, several weaknesses in the curriculum have been identified for further continuous improvements. Recommendations and suggestions for curriculum improvement also include the enhancement of technical skills and competences of students towards fulfilling the needs and demand of the automotive industries.

Keywords: technical education and vocational training (TEVT), industrial training attachment (INTRA), curriculum improvement, automotive industry

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Authors: Anton Grobler

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Background: Psychological capital (PsyCap), consisting of Hope, Optimism, Resilience, and Self-efficacy, is a popular positive organisational behaviour construct utilised in the studying employee work and behavioral attitudes. Various scholars believe however that further validity research should be conducted on the PsyCap questionnaire (PCQ), outside of the founding research team and in more diverse settings, for the purpose of this paper, within the diverse South African (SA) context. Aim: The purpose of this study was to investigate the construct validity of the PCQ with specific reference to its psychometric properties within the diverse SA context. Setting: The sample includes a total of 1 749 respondents, ± 60 each from 30 organisations in South Africa. Method: This study utilised a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender) of the South African workforce. A multi-factorial model was statistically explored and confirmed (with exploratory factor analysis [EFA] and confirmatory factor analysis [CFA] respectively). Results: The study yielded a three-factor solution, with Hope and Optimism as a combined factor and Resilience and Self-efficacy made up of a reconfigured set of substantively justifiable items. Three items of the original 24 items were found not to be suitable. The three factors showed good psychometric properties, good fit (in support of construct validity) and acceptable levels of convergent and discriminant validity. Conclusion: The results support the original conceptualisation of PsyCap, although with a unique structural configuration. This resonates with the notion of scholars that further research should be conducted within diverse settings. This is necessary to ensure the valid measurement of the construct, which is considered to be one of the four criteria for a construct to be categorised as a positive organisational behaviour construct.

Keywords: positive organisational behaviour, psychological capital, hope, optimism, resilience, self-efficacy, construct validity

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Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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Sri Lanka is one of the prominent countries for the coir production. The coir is one of the by-products of the coconut and the coir industry is considered to be one of the traditional industries in Sri Lanka. Because of the inherent nature of the coir industry, labourers play a significant role in the coir production process. The study has analyzed the determinants of the income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division. Simple random sampling was used to generate a sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews, and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were performed for mean comparison. The findings revealed that the household level coir yarn industry is dominated by the female workers and it was identified that fewer numbers of workers have engaged in this industry as the main occupation. In addition to that, elderly participation in the industry is higher than the younger participation and most of them have engaged in the industry as a source of extra income. Level of education, the methods of engagement, satisfaction, engagement in the industry by the next generation, support from the government, method of government support, working hours per day, employed as a main job, number of completed units per day, suffering from job related diseases and type of the diseases were related with income level of household level coir yarn laboures. The recommendations as to flourish in future includes, technological transformation for coir yarn production, strengthening the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programmes, the establishment of the labourers’ association, the initiation of micro credit schemes and better consideration about the job oriented diseases.

Keywords: coir yarn, determinants, income, Sri Lanka

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Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction and Aim: This study assessed sexual behaviours among men and women aged 15 to 49 years in Tehran. Material and Methods: This was a cross-sectional study conducted on 755 men and women aged 15 to 49 years who were residents of Tehran. To select the participants, a multistage, cluster, random sampling method was used and included different regions of Tehran. The data were collected using the WHO-endorsed Questionnaire of Sexual and Reproductive Health. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 20. Sexual and reproductive health (SRH) behaviours was a scale variable that was constructed from items of six sections: sexual experiences, characteristics of the first sexual partner, characteristics of the first intercourse, next sexual contact and the consequences of the first sexual contact, homosexual experiences and the causes of sexual abstinence. Results: The mean age at the time of sexual intercourse with penetration (vaginal, anal) was 19.88 in men and 21.82 in women. Multivariate analysis using linear regression showed that by controlling for other variables, gender had a significant relationship with having sexual experience, mean age of first sexual intercourse, and being multi-partner. Thus, women with sexual experience were 0.158 units less than men. The mean age of first intercourse in women was 1.57 units higher than men and being a multi-partner in women was 0.247 less than men (P < 0.001). Sexual experience in very religious and relatively religious individuals was 0.332 and 0.218 units less than those for whom religion did not matter (P < 0.001). 25.6% of men and 40.7% of women who did not have sexual experience at the time of the study stated that their reason for abstinence was their unwillingness to have sex (P < 0.05). 35.9% of men and 16.5% of women stated that the reason for abstinence was not providing a suitable opportunity (P < 0.001). 4.7% of men and 1.7% of women had sexual attraction to the same sex. The difference between men and women was significant (P < 0.001). Conclusion: Sexual relation is also present in singles and younger groups and is not limited to married or final marriage candidates. Therefore, more evaluation should be done in national research and interventions for sexual and reproductive health services should be done at the macro level of policy making.

Keywords: sexual behaviours, Iranian men and women, Iran, cross-sectional study

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Authors: Priya Nambisan, Lien B. Nguyen

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Women participate extensively in the healthcare field, professionally (as physicians, nurses, dietitians, etc.) as well as informally (as caregivers at home). This provides them with a better understanding of the health needs of people. Women are also in the forefront of using social media and other mobile health related apps. Further, many health mobile apps are specifically designed for women users. All of these indicate the potential for women to be successful entrepreneurs in healthcare, especially, in the area of mobile health app development. However, extant research in entrepreneurship has paid limited attention to women entrepreneurship in healthcare. The objective of this study is to determine the key factors that shape the intentions and actions of women entrepreneurs with regard to their entrepreneurial pursuits in the healthcare field. Specifically, the study advances several hypotheses that relate key variables such as personal skills and capabilities, experience, support from institutions and family, and perceptions regarding entrepreneurship to individual intentions and actions regarding entrepreneurship (specifically, in the area of mobile apps). The study research model will be validated using survey data collected from potential women entrepreneurs in the healthcare field – students in the area of health informatics and engineering. The questionnaire-based survey relates to woman respondents’ intention to become entrepreneurs in healthcare and the key factors (independent variables) that may facilitate or inhibit their entrepreneurial intentions and pursuits. The survey data collection is currently ongoing. We also plan to conduct semi-structured interviews with around 10-15 women entrepreneurs who are currently developing mobile apps to understand the key issues and challenges that they face in this area. This is an exploratory study and as such our goal is to combine the findings from the regression analysis of the survey data and that from the content analysis of the interview data to inform on future research on women entrepreneurship in healthcare. The study findings will hold important policy implications, specifically for the development of new programs and initiatives to promote women entrepreneurship, particularly in healthcare and technology areas.

Keywords: women entrepreneurship, healthcare, mobile apps, health apps

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Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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Authors: Obasa Joshua Ifeoluwa

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Phonetics is the foundation and most important part of language learning. This article, through an acoustic experiment as well as using Praat software, uses Yoruba students’ Chinese consonants, vowels, and tones pronunciation to carry out a visual comparison with that of native Chinese speakers. This article is aimed at Yoruba native speakers learning Chinese phonetics; therefore, Yoruba students are selected. The students surveyed are required to be at an elementary level and have learned Chinese for less than six months. The students selected are all undergraduates majoring in Chinese Studies at the University of Lagos. These students have already learned Chinese Pinyin and are all familiar with the pinyin used in the provided questionnaire. The Chinese students selected are those that have passed the level two Mandarin proficiency examination, which serves as an assurance that their pronunciation is standard. It is discovered in this work that in terms of Mandarin’s consonants pronunciation, Yoruba students cannot distinguish between the voiced and voiceless as well as the aspirated and non-aspirated phonetics features. For instance, while pronouncing [ph] it is clearly shown in the spectrogram that the Voice Onset Time (VOT) of a Chinese speaker is higher than that of a Yoruba native speaker, which means that the Yoruba speaker is pronouncing the unaspirated counterpart [p]. Another difficulty is to pronounce some affricates like [tʂ]、[tʂʰ]、[ʂ]、[ʐ]、 [tɕ]、[tɕʰ]、[ɕ]. This is because these sounds are not in the phonetic system of the Yoruba language. In terms of vowels, some students find it difficult to pronounce some allophonic high vowels such as [ɿ] and [ʅ], therefore pronouncing them as their phoneme [i]; another pronunciation error is pronouncing [y] as [u], also as shown in the spectrogram, a student pronounced [y] as [iu]. In terms of tone, it is most difficult for students to differentiate between the second (rising) and third (falling and rising) tones because these tones’ emphasis is on the rising pitch. This work concludes that the major error made by Yoruba students while pronouncing Chinese sounds is caused by the interference of their first language (LI) and sometimes by their lingua franca.

Keywords: Chinese, Yoruba, error analysis, experimental phonetics, consonant, vowel, tone

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Authors: Fatemeh Ghaemi, Padideh Feyzi, Zohreh Dortaj

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Cancer is one of the common diseases that may cause death due to malignancy. The physical problems of cancer patients can have an impact on the psychological and social aspects of their lives. Depression is one of these problems that threaten the lives of these patients and can also reduce their quality of life. Helping patients with cancer to find meaning in life can increase their level of health and improve their quality of life. This study thus examines the effectiveness of group logotherapy on the depression and quality of life of women with cancer. Depression was measured using the Beck Depression Inventory (BDI) and quality of life was measured using Quality of Life Questionnaire (WHOQL) with acceptable and reliable indicators in the pre-test and post-test stages. The experimental group received group therapy in eight, sixty-minute sessions and the control group did not receive any intervention. After collecting the questionnaires, the mean and standard deviations were used to describe the data and the statistical method of multivariate analysis of covariance was used at the significant level (P≤0.05). The results were analyzed using SPSS(22). The results showed that there was a significant difference between post-test depression scores in the experimental group and the control group. Also, there was a significant difference between the post-test scores of quality of life and its components (psychological, physical, social and environmental health) in the experimental group and control group. The findings of this study showed the effectiveness of group logotherapy in decreasing depression and improving the quality of life of cancer patients. By focusing the minds of the people on the present and changing the attitude of the human being towards themselves, life and environment can help the depressed people, and by influencing the individual's view of himself, accepting responsibility, accepting life with purpose, paying attention to life uniformly, it allows a person to maintain his quality of life even with cancer. Therefore, it is recommended that this approach be used as a group intervention in hospitals and care units for cancer patients and even in people with certain diseases.

Keywords: cancer, depression, group psychiatry, quality of life

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Authors: Zachary Bolo Awino

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The need to gain and sustain a competitive advantage is overwhelming for businesses, especially now with cut throat competition. Innovation has been suggested as one way of gaining the advantage sustainably. But innovation can only happen within certain enabling environment and cultures. This study had one hypothesis: that there is no relationship between innovation and performance. This research was a cross sectional survey in which variables of interest are not controlled or manipulated. The cross sectional survey design is also appropriate for this study as it improves accuracy in generalizing findings, since it involves detailed study of a unit. Also known as one shot study, this design enhances uniform data collection and comparison across respondents. The population of the study was the 55 publicly quoted corporations in the Nairobi Securities Exchange (NSE) as at October 2013.The number was initially envisaged to be 60 but 5 firms were delisted or suspended during the year, hence leaving 55 firms as the population of study. The rationale for the choice for these firms is because they cut across the key economic sectors in Kenyan economy which include agriculture, commercial and services, manufacturing, finance and investment. This was a census survey and targeted all the firms listed at the Nairobi Securities Exchange as of October 2013. The primary data for the study was collected through the use of a structured questionnaire. A five point type Likert scale ranging from 1 - denoting to a less event to 5 - denoting to a greater extent was used. Respondents were from senior management of NSE. From the analyses, the study established that there was a strong positive relationship between innovation and performance, and organization innovation significantly contributes to employee engagement. Also there was a moderate positive relationship between innovation and performance. The study drew expressions of interrelations between various variables, offered generalization of understanding and meaning of these relationships, thus expanding the frontiers of knowledge both theoretical and practical with respect to innovation and firm performance. Major conclusion in this study was that there is a positive strong relationship between innovation and major measures of firm performance.

Keywords: emperical, innovation, NSE, organizations, performance

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: Sharmila Dahal Paudel

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Background: There are around twenty-four thousand to twenty-eight thousand Female Sex Workers in Nepal. FSWs are the vulnerable groups for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infections which directly and indirectly ease to reduce the quality of life of such groups. Due to their highly marginalized status, FSWs in Nepal have limited access to information about reproductive health and safe sex practices. The objectives of the study are to assess the quality of life of female sex workers and the factors affecting them. Materials and Methods: A descriptive cross-sectional study with methodological triangulation was conducted among 108 FSWs on the basis of service record of selected organization of Pokhara valley. The complete enumerative sampling was used to select FSWs. Structured interview schedule, WHOQOL-BREF and in-depth questionnaire were used to collect the data. The descriptive and inferential statistics were used to interpret the result. Results: The mean age of participants were 23.44 years and the mean quality of life score was 174.06 ranging from 56.54 to 370.78. Among the domain scores, the mean score is highest in social domain (55.89) followed by physical (45.42), psychological (39.27) and the environmental (34.23). Regarding the association of QOL with socio-demographic, occupation and health-related variables, the multi-linear regression suggests that the satisfaction with occupation was highly significant with the total QOL score (B=-50.50, SE=10.46; p= <0.001) and there is negative relation between QOL and feeling of exploitation and facing STI problems. This means those who feels exploited have significantly less QOL comparing with those who did not feel the same. In correlation analysis, all the domains are positively co-related with each domain which is found to be significant at 1% level of significance. Conclusion: The highest mean score was in social domain, and the lowest is in environmental domain which suggests that the items included in environmental domains could not be utilized or hindrance were there.

Keywords: FSWs, HIV, QOL, WHOQOL-BREF

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Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Subhro Sarkar, Umesh Mishra

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Agartala Municipal Council (AMC) is the municipal body which regulates and governs the Agartala city. MSW management may be proclaimed as a tool which rests on the principles of public health, economy, engineering and other aesthetic or environmental factors by dealing with the controlled generation, collection, transport, processing and disposal of MSW. Around 220-250 MT of solid waste per day is collected by AMC out of which 12-14 MT is plastic and is disposed of in Devendra Chandra Nagar dumping ground (33 acres), nearly 12-15 km from the city. A survey was performed to list down the prevailing operations conducted by the AMC which includes road sweeping, garbage lifting, carcass removal, biomedical waste collection, dumping, and incineration. Different types of vehicles are engaged to carry out these operations. Door to door collection of garbage is done from the houses with the help of 220 tricycles issued by 53 NGOs. The location of the dustbin containers were earmarked which consisted of 4.5 cum, 0.6 cum containers and 0.1 cum containers, placed at various locations within the city. The total household waste was categorized as organic, recyclable and other wastes. It was found that East Pratapgarh ward produced 99.3% organic waste out of the total MSW generated in that ward which is maximum among all the wards. A comparison of the waste generation versus the family size has been made. A questionnaire for the survey of MSW from household and market place was prepared. The average waste generated (in kg) per person per day was found out for each of the wards. It has been noted that East Jogendranagar ward had a maximum per person per day waste generation of 0.493 kg/day.In view of the studies made, it has been found that AMC has failed to implement MSWM in an effective way because of the unavailability of suitable facilities for treatment and disposal of the large amount of MSW. It has also been noted that AMC is not following the standard procedures of handling MSW. Transportation system has also been found less effective leading to waste of time, money and manpower.

Keywords: MSW, waste generation, solid waste disposal, management

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: Kathryn Strachan, Sameer Otoom, Amal AL-Gallaf, Ahmed Al Ansari

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Introduction: Introducing a reliable method to select graduates for an award in higher education can be challenging but is not impossible. Multisource feedback (MSF) is a popular assessment tool that relies on evaluations of different groups of people, including physicians and non-physicians. It is useful for assessing several domains, including professionalism, communication and collaboration and may be useful for selecting the best interns to receive a University award. Methods: 16 graduates responded to an invitation to participate in the student award, which was conducted by the Royal College of Surgeons of Ireland-Bahrain Medical University of Bahrain (RCSI Bahrain) using the MSF process. Five individuals from the following categories rated each participant: physicians, nurses, and fellow students. RCSI Bahrain graduates were assessed in the following domains; professionalism, communication, and collaboration. Mean and standard deviation were calculated and the award was given to the graduate who scored the highest among his/her colleagues. Cronbach’s coefficient was used to determine the questionnaire’s internal consistency and reliability. Factor analysis was conducted to examine for the construct validity. Results: 16 graduates participated in the RCSI-Bahrain interns’ award based on the MSF process, giving us a 16.5% response rate. The instrument was found to be suitable for factor analysis and showed 3 factor solutions representing 79.3% of the total variance. Reliability analysis using Cronbach’s α reliability of internal consistency indicated that the full scale of the instrument had high internal consistency (Cronbach’s α 0.98). Conclusion: This study found the MSF process to be reliable and valid for selecting the best graduates for the interns’ awards. However, the low response rates may suggest that the process is not feasible for allowing the majority of the students to participate in the selection process. Further research studies may be required to support the feasibility of the MSF process in selecting graduates for the university award.

Keywords: MSF, RCSI, validity, Bahrain

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Authors: Mashael AlSalem

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While research into language assessment has expanded in recent years, few if any studies to date have targeted the nature of thought processes used by teachers when constructing classroom-based assessment. This study reports on teachers’ conceptions of English grammar assessment and their classroom assessment practices in their Saudi higher educational facilities. A mixed-method approach using both qualitative and quantitative research instruments was employed to elicit teachers’ perceptions of English grammar assessment and their relationship to their current practices. Participants of the study included EFL teachers from 4 different educational facilities: King Saudi University, Princess Noura University, Imam Mouhamed Islamic University, and Institute of Public Administration. Data collection involved questionnaire (N=100), semi-structured interviews (N=30), retrospective thinking (N=20), and document analysis (N=20). Activity theory is used as an interpretive framework to explore and investigate the entire system of constructing classroom-based assessment. Preliminary findings reveal several similarities and differences between the participants’ stated beliefs and their current practices of assessing English grammar. Findings also showed that teacher participant’s beliefs about how English grammar should be assessed are influenced mostly by prior learning experience as well as their teaching instruction practices. Their practices, on the other hand, was more guided by educational policies and lack of teacher training in the field of assessment, among other factors. This research makes a significant contribution to knowledge in three different areas: it enriches the literature on language teacher cognition; it builds on the body of research on language classroom assessment, and it expands on the possibilities to use AC to investigate the relationship between teachers’ beliefs and practices.

Keywords: activity theory, classroom-based assessment, language teacher cognition, mixed method approach

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Authors: Tuba Senel Zor, Oktay Aslan

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With current trends in nanoscience and nanotechnology (NST), scientists have paid much attention to education and nanoliteracy in parallel with the developments on these fields. To understand the advances in NST research requires a population with a high degree of science literacy. All citizens should soon need nanoliteracy in order to navigate some of the important science-based issues faced to their everyday lives. While the fields of NST are advancing rapidly and raising their societal significance, general public’s awareness of these fields has remained at a low level. Moreover, students enrolled different education levels and teachers don’t have awareness at expected level. This problem may be stemmed from inadequate education and training. To remove the inadequacy, teachers have greatest duties and responsibilities. Especially science teachers at all levels need to be made aware of these developments and adequately prepared so that they are able to teach about these advances in a developmentally appropriate manner. If the teachers develop understanding and awareness of NST, they can also discuss the topic with their students. Therefore, the awareness and conceptual understandings of both the teachers who will teach science to students and the students who will be introduced about NST should be increased, and the necessary training should be provided. The aim of this study was to examine the effect of NST education on preservice science teachers’ awareness of NST. The study was designed in one group pre-test post-test quasi-experimental pattern. The study was conducted with 32 preservice science teachers attending the Elementary Science Education Program at a large Turkish university in central Anatolia. NST education was given during five weeks as two hours per week. Nanoscience and Nanotechnology Awareness Questionnaire was used as data collected tool and was implemented for pre-test and post-test. The collected data were analyzed using Statistical package for the Social Science (SPSS). The results of data analysis showed that there was a significant difference (z=6.25, p< .05) on NST awareness of preservice science teachers after implemented NST education. The results of the study indicate that NST education has an important effect for improving awareness of preservice science teachers on NST.

Keywords: awareness level, nanoliteracy, nanoscience and nanotechnology education, preservice science teachers

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Authors: Evangeline Mbah, Margret Okeke, Agbo Joseph

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Agriculture was primarily a rural activity in Nigeria, but due to increasing demand for food and jobs for many urban dwellers, it became necessary for urban households to embark on farming as a means of improving household food security and additional income for economic empowerment. Urban agriculture serves as a veritable tool for poverty reduction among people living in urban areas mostly low-income earners and unemployed. The survey was conducted to identify key challenges encountered by households in Makurdi metropolis of Benue state, Nigeria who are engaged in urban agriculture. A well-structured questionnaire was used to collect data from a sample of respondents used for the study. Data were analyzed using frequency, percentage, mean score and standard deviation. Results show that a greater percentage (46.0%) of the respondents engaged in cultivation of leafy vegetable, 22.0% cultivated cassava, 21.0% planted sweet potato, 18.0% cultivated tomato while 56.0% reared poultry, 23.0% kept goat, among others. Sources of agricultural information indicated by the respondents were family members/relations (85.0%), friends/neighbours (73.0%), radio (68.0%), extension agents (57.0%), etc. Major challenges encountered by the respondents in urban agriculture include inadequate size of farmland (M= 2.72), lack of access to credit facilities (M= 2.63), lack of funds (M= 2.50), high cost of labour (M= 2.49), insecurity of lands (M= 2.46), theft of crops at maturity (M= 2.38), lack of farm inputs such as improved varieties of seeds, fertilizer and exotic breeds of livestock (M= 2.23), destruction of crops by stray farm animals (M= 1.96), among others. The study recommends that there is a need for adequate provision of farm inputs by the government at all levels at a subsidized rate in order to reduce the cost of production and enhance optimum productivity.

Keywords: urban, agriculture, household, challenges, Makurdi, Nigeria

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Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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