Search results for: perceived barriers

Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Minnie Y. Teng, Kathy Xie, Jarus Tal

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Rationale: The traditional approach to community programs for children with mental and/or developmental challenges often involves segregation from typically-developing peers. However, studies show that inclusive education improves children’s quality of life, self-concept, and long term health outcomes. Investigating factors that influence inclusion can thus have important implications in the design and facilitation of community programs such that all children - across a spectrum of needs and abilities - may benefit. Objectives: This study explores barriers and facilitators to inclusive community programming for children aged 0 to 12 with developmental/mental challenges. Methods: Using a participatory-action research methodology, semi-structured focus groups and interviews will be used to explore perspectives of sighted students, instructors, and staff. Data will be transcribed and coded thematically. Practice Implications or Results: By having a deeper understanding of the barriers and facilitators to inclusive programming in the community, researchers can work with the broader community to facilitate inclusion in children’s community programs. Conclusions: Expanding inclusive practices may improve the health and wellbeing of the pediatric populations with disabilities, which consistently reports lower levels of participation. These findings may help to identify gaps in existing practices and ways to approach them.

Keywords: aquatic programs, children, disabilities, inclusion, community programs

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Yurdum Cokadar

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The United States is the country where the majority of highly skilled immigrants are hosted. Two-thirds of foreign-born migrants from Turkey - an underrepresented and understudied immigrant group in the United States - are highly skilled. Generated by the aim of filling this gap in the literature, the motivation of this research is to understand highly skilled Turkish immigrant women’s integration into the U.S. labor market, including barriers that they face and strategies they develop to rebuild their career after relocation. The in-depth interviews of 20 highly skilled Turkish women residing in the U.S. revealed that the majority of women participants are either not integrated into the labor market, occupy positions below their skill, or cannot reach the same upper segments of the labor market in the host country, arising from a range of structural and personal barriers interplaying in their career trajectories. Furthermore, many of them cannot transfer their social and cultural capital gained in their home country into the United States. The labor market participation process of these women is analyzed in the light of Bourdieu’s theory of capital and the intersectional approach of gender, class and ethnicity in order to understand the positions of highly skilled immigrant women in the host country labor market.

Keywords: deskilling, gender, class and ethnicity, highly skilled women immigrants, integration into the U.S. the labor market, labor market participation, skilled migration, theory of capital

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Authors: Seyed Mohammadbagher Jafari, Izmeera Shiham, Masoud Arianfar

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The increased usage of Social media for different uses in turn makes it important to develop an understanding of users and their attitudes toward these sites, and moreover, the uses of such sites in a broader perspective such as broadcasting. This quantitative study addressed the problem of factors influencing the adoption of social media as a medium of public service broadcasting in the Republic of Maldives. These powerful and increasingly usable tools, accompanied by large public social media datasets, are bringing in a golden age of social science by empowering researchers to measure social behavior on a scale never before possible. This was conducted by exploring social responses on the use of social media. Research model was developed based on the previous models such as TAM, DOI and Trust combined model. It evaluates the influence of perceived ease of use, perceived usefulness, trust, complexity, compatibility and relative advantage influence on the adoption of social Media. The model was tested on a sample of 365 Maldivian people using survey method via questionnaire. The result showed that perceived usefulness, trust, relative advantage and complexity would highly influence the adoption of social media.

Keywords: adoption, broadcasting, maldives, social media

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Authors: Wan-Ling Chang, Hsiu-Ju Huang, Jui-Hsiu Chang

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In 2004, the Ministry of Foreign Affairs Taiwan launched ‘An Arrangement on Working Holiday Scheme’ with 15 countries including New Zealand, Japan, Canada, Germany, South Korea, Britain, Australia and others. The aim of the scheme is to allow young people to work and study English or other foreign languages. Each year, there are 30,000 Taiwanese youths applied for participating in the working holiday schemes. However, frequent accidents could cause huge medical expenses and post-delivery fee, which are usually unaffordable for most families. Therefore, this study explored the relationship among perceived risk toward working holiday, insurance product knowledge, brand image and insurance purchase intention for Taiwanese youths who plan to apply for working holiday. A survey questionnaire was distributed for data collection. A total of 316 questionnaires were collected for data analyzed. Data were analyzed using descriptive statistics, independent samples T-test, one-way ANOVA, correlation analysis, regression analysis and hierarchical regression methods of analysis and hypothesis testing. The results of this research indicate that perceived risk has a negative influence on insurance purchase intention. On the opposite, product knowledge has brand image has a positive influence on the insurance purchase intention. According to the mentioned results, practical implications were further addressed for insurance companies when developing a future marketing plan.

Keywords: insurance product knowledges, insurance purchase intention, perceived risk, working holiday

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Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

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To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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Authors: Sara Gallo, Margherita Pasini, Margherita Brondino, Daniela Raccanello, Roberto Burro, Elisa Menardo

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Most of the studies on the ability of environments to recover people’s cognitive resources have been conducted in laboratory using simulated environments (e.g., photographs, videos, or virtual reality), based on the implicit assumption that exposure to simulated environments has the same effects of exposure to real environments. However, the technical characteristics of simulated environments, such as the dynamic or static characteristics of the stimulus, critically affect their perception. Measuring perceived restorativeness in situ rather than in laboratory could increase the validity of the obtained measurements. Personal mobile devices could be useful because they allow accessing immediately online surveys when people are directly exposed to an environment. At the same time, it becomes important to develop short and reliable measuring instruments that allow a quick assessment of the restorative qualities of the environments. One of the frequently used self-report measures to assess perceived restorativeness is the “Perceived Restorativeness Scale” (PRS) based on Attention Restoration Theory. A lot of different versions have been proposed and used according to different research purposes and needs, without studying their validity. This longitudinal study reported some preliminary validation analyses on a short version of original scale, the PRS-6, developed to be quick and mobile-friendly. It is composed of 6 items assessing fascination and being-away. 102 Italian university students participated to the study, 84% female with age ranging from 18 to 47 (M = 20.7; SD = 2.9). Data were obtained through a survey online that asked them to report their perceived restorativeness of the environment they were in (and the kind of environment) and their positive emotion (Positive and Negative Affective Schedule, PANAS) once a day for seven days. Cronbach alpha and item-total correlations were used to assess reliability and internal consistency. Confirmatory Factor Analyses (CFA) models were run to study the factorial structure (construct validity). Correlation analyses between PRS and PANAS scores were used to check discriminant validity. In the end, multigroup CFA models were used to study measurement invariance (configural, metric, scalar, strict) between different mobile devices and between day of assessment. On the whole, the PRS-6 showed good psychometric proprieties, similar to those of the original scale, and invariance across devices and days. These results suggested that the PRS-6 could be a valid alternative to assess perceived restorativeness when researchers need a brief and immediate evaluation of the recovery quality of an environment.

Keywords: restorativeness, validation, short scale development, psychometrics proprieties

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Authors: Jasmine Adela Mutang, Rosnah Ismail, Chua Bee Seok, Ferlis Bahari, Lailawati Madlan, Walton Wider, Rickless Das

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Waste projection is increasing and most landfills in Malaysia are running out of space. Due to that, waste management is now becoming a major challenge. The most sustainable solution is by practicing sustainable practices such as recycling. Since 1993 the government has launched several recycling campaigns and implemented the National Recycling Policy. However, public participation is still very low. Only 10.5% of solid waste was recycled up to now which is far below than of in developed countries. Nevertheless the government is optimistic that the target of 22% recycling by 2020 will be achieved if there is a positive flow pattern in sustainable practices in particular recycling behavior among Malaysian. Understanding public motivations towards recycling domestic waste are important to improve current recycling rate. Thus this study attempts to identify what are the possible motivations and hindrances for the public to recycle. Open-ended questions format were administered to 484 people in Kota Kinabalu, Sabah, Malaysia. Two specific questions we asked to explore their general determinants and barriers in practicing recycling: “What motivates you to recycle?” and “What are the barriers you encountered in doing recycling activities?” Thematic analysis was conducted on the open-ended questions in which themes were created with the raw comments. It was found that the underlying recycling motivations are awareness’ towards the environment, benefits to the society and individual, and social influence. Non participations are influence by attitudes, commitment, facilities, knowledge, inconvenience, and enforcement.

Keywords: recycling motivation, recycling barrier, sustainable, household waste

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: Kibbeum Na

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Previous gamification research has produced mixed results regarding the effectiveness of gamified learning. One possible explanation for this is that individuals perceive the game elements differently. Cognitive Evaluation Theory posits that external rewards can boost or undermine intrinsic motivation, depending on whether the rewards are perceived as informational or controlling. This research tested the hypothesis that game elements can be perceived as either informational feedback or external reward, and the motivational impact differ accordingly. An experiment was conducted using an educational math puzzle to compare the motivation and performance as a result of different perceived affordances game elements. Participants were primed to perceive the game elements as either informational feedback or external reward, and the duration of an attempt to solve the unsolvable puzzle – amotivation indicator – and the puzzle score – a performance indicator–were measured with the game elements incorporated and then without the game elements. Badges and points were deployed as the main game elements. Results showed that, regardless of priming, a significant decrease in performance occurred when the game elements were removed, whereas the control group who solved non-gamified math puzzles maintained their performance. The undermined performance with gamification removal indicates that learners may perceive some game elements as controlling factors irrespective of the way they are presented. The results of the current study also imply that some game elements are better not being implemented to preserve long-term performance. Further research delving into the extrinsic reward-like nature of game elements and its impact on learning motivation is called for.

Keywords: cognitive Evaluation Theory, game elements, gamification, motivation, motivational affordance, performance

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Authors: Muhamamd Shahid Farooq, Maazan Zafar, Rizawana Akhtar

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E-learning technologies are the blessings of advancements in science and technology. These facilitate the learners to get information at any place and any time by improving their self-confidence, self-efficacy and effectiveness in teaching learning process. E-learning provides an individualized learning experience for learners and remove barriers faced by students during new and creative ways of gaining information. It provides a wide range of facilities to enable the teachers and students for effective and purposeful learning. This study was conducted to explore the attitudes of university students and teachers towards e-learning working in a metropolitan university of Pakistan. The personal, institutional and technological characteristics of the teachers and students of higher education institution effect the adoption of e-learning. For this descriptive study 449 students and 35 university teachers were surveyed by using a Likert scale type questionnaire consisting of 52 statements relating to six factors "perceived usefulness, intention to adopt e-learning, ease of e-learning use, availability resources, e-learning stressors, and pressure to use e-learning". Data were analyzed by making comparisons on the basis of different demographic factors. The findings of the study show that both type of respondents have positive attitude towards e-learning. However, the male and female respondents differ in their opinion for e-learning implementation.

Keywords: e-learning, ICT, e-sources of learning, questionnaire

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Authors: Adedayo Racheal Agbonna

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The rising level of graduate unemployment in Nigeria has brought about the introduction of entrepreneurship education as a career option for self–reliance and self-employment. Sequel to this, it is important to have an understanding of the determining factors of entrepreneurial intention. Therefore this research empirically investigated the influence of entrepreneurship education on entrepreneurial intention of undergraduate students of selected universities in Ogun State, Nigeria. The study is significant to researchers, university policy makers, and the government. Survey research design was adopted in the study. The population consisted of 17,659 final year undergraduate students universities in Ogun State. The study adopted stratified and random sampling technique. The table of sample size determination was used to determine the sample size for this study at 95% confidence level and 5% margin error to arrive at a sample size of 1877 respondents. The elements of population were 400 level students of the selected universities. A structured questionnaire titled 'Entrepreneurship Education and students’ Entrepreneurial intention' was administered. The result of the reliability test had the following values 0.716, 0.907 and 0.949 for infrastructure, perceived university support, and entrepreneurial intention respectively. In the same vein, from the construct validity test, the following values were obtained 0.711, 0.663 and 0.759 for infrastructure, perceived university support and entrepreneurial intention respectively. Findings of this study revealed that each of the entrepreneurship education variables significantly affected intention University infrastructure B= -1.200, R²=0.679, F (₁,₁₈₇₅) = 3958.345, P < 0.05) Perceived University Support B= -1.027, R²=0.502, F(₁,₁₈₇₅) = 1924.612, P < 0.05). The perception of respondents in public university and private university on entrepreneurship education have a statistically significant difference [F(₁,₁₈₇₅) = 134.614, p < 0.05) α F(₁,₁₈₇₅) = 363.439]. The study concluded that entrepreneurship education positively influenced entrepreneurial intention of undergraduate students in Ogun State, Nigeria. Also, university infrastructure and perceived university support have negative and significant effect on entrepreneurial intention. The study recommended that to promote entrepreneurial intention of university undergraduate students, infrastructures and the university support that can arouse entrepreneurial intention of students should be put in place.

Keywords: entrepreneurship education, entrepreneurial intention, perceived university support, university infrastructure

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Authors: N. P. Tsephe, S. D. Eyono Obono

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Rural tourism is usually associated with rural development because it has strong linkages to rural resources; but it remains underdeveloped compared to urban tourism. This underdevelopment of rural tourism serves as a motivation for this study whose aim is to examine the factors affecting the perceived satisfaction of rural tourists. The objectives of this study are: to identify and design theories and models on rural tourism satisfaction, and to empirically validate these models and theories through a survey of tourists from the Malealea Lodge which is located in the Mafeteng District, in the Mountain Kingdom of Lesotho. Data generated by the collection of questionnaires used by this survey was analyzed quantitatively using descriptive statistics and correlations in SPSS after checking the validity and the reliability of the questionnaire. The main hypothesis behind this study is the relationship between the demographics of rural tourists, the motivation, and their satisfaction of tourists, as supported by existing literature; except that motivation is measured in this study according to three dimensions: push factors, pull factors, and perceived usefulness of ICT's in the rural tourism experience. Findings from this study indicate that among the demographics factors, continent of origin and marital status influence the satisfaction of rural tourists; and their occupation affects their perceptions on the use of ICT's in rural tourism. Moreover, only pull factors were found to influence the satisfaction of rural tourists.

Keywords: digital world, motivation, rural tourism, satisfaction

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Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: Gyoomi Kim, Jiyoung Bae

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In the field of language education research, there are not many tries to empirically examine learners’ acceptance behavior and related factors of mobile-assisted language learning (MALL). This study is one of the few attempts to propose an integrated theoretical framework that explains MALL users’ acceptance behavior and potential factors. Constructs from technology acceptance model (TAM) and MALL research are tested in the integrated framework. Based on previous studies, a hypothetical model was developed. Four external variables related to the MALL user’s acceptance behavior were selected: subjective norm, content reliability, interactivity, self-regulation. The model was also composed of four other constructs: two latent variables, perceived ease of use and perceived usefulness, were considered as cognitive constructs; attitude toward MALL as an affective construct; behavioral intention to use MALL as a behavioral construct. The participants were 438 undergraduate students who enrolled in an intensive English program at one university in Korea. This particular program was held in January 2018 using the vacation period. The students were given eight hours of English classes each day from Monday to Friday for four weeks and asked to complete MALL courses for practice outside the classroom. Therefore, all participants experienced blended MALL environment. The instrument was a self-response questionnaire, and each construct was measured by five questions. Once the questionnaire was developed, it was distributed to the participants at the final ceremony of the intensive program in order to collect the data from a large number of the participants at a time. The data showed significant evidence to support the hypothetical model. The results confirmed through structural equation modeling analysis are as follows: First, four external variables such as subjective norm, content reliability, interactivity, and self-regulation significantly affected perceived ease of use. Second, subjective norm, content reliability, self-regulation, perceived ease of use significantly affected perceived usefulness. Third, perceived usefulness and perceived ease of use significantly affected attitude toward MALL. Fourth, attitude toward MALL and perceived usefulness significantly affected behavioral intention to use MALL. These results implied that the integrated framework from TAM and MALL could be useful when adopting MALL environment to university students or adult English learners. Key constructs except interactivity showed significant relationships with one another and had direct and indirect impacts on MALL user’s acceptance behavior. Therefore, the constructs and validated metrics is valuable for language researchers and educators who are interested in MALL.

Keywords: blended MALL, learner factors/variables, mobile-assisted language learning, MALL, technology acceptance model, TAM, theoretical framework

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Authors: Shiva Hashemi, Azizan Marzuki, S. Kiumarsi

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In recent years, conference destinations have been highly competitive; therefore, it is necessary to know about the behaviours of conference participants such as the process of their decision-making and the assessment of perceived conference quality. A conceptual research framework based on the Theory of Planned Behaviour model is presented in this research to get better understanding factors that influence it. This research study highlights key factors presented in previous studies in which behaviour intentions of participants are affected by the quality of conference. Therefore, this study is believed to provide an idea that conference participants should be encouraged to contribute to the quality and behaviour intention of the conference.

Keywords: conference, attendees, service quality, perceives value, trust, behavioural intention.

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Authors: Khwaja Bahman Qaderi, Noorullah Rafiqee

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Background: With today's increasing Internet users, e-commerce has become a viable model for strengthening relationships between sellers, entrepreneurs, and consumers due to its speed, efficiency, and cost reduction. Agriculture is the economic backbone for 80 percent of the Afghan population. According to MCIT statistics, there are currently around 10 million internet users in Afghanistan. With this data, it was expected that Afghan people should have utilized e-commerce in their agricultural aspects, although it appears to be less used. Objective: This study examines the scope of e-commerce in Afghanistan's agriculture enterprises, how they harness the potential of internet users, and what obstacles they face in implementing e-commerce in their businesses. Method: The study distributed a 39-question questionnaire to agribusinesses in five different zones of Afghanistan. After extracting the responses and excluding the incomplete questionnaires, 280 were included in the analysis step to perform a non-parametric sign test. Result: E-commerce in Afghanistan faces four major political, economic, Internet, and technological obstacles, and no company in the country has implemented e-commerce. In addition, e-commerce is still in its infancy among agricultural companies in the country. Internet use is still primarily limited to email and sharing product images on Facebook & Instagram for advertising purposes. There are no companies that conduct international transactions via the Internet. Conclusion: This study contributes to knowing the challenges and barriers that the agriculture e-commerce faces in Afghanistan to find the effective solutions to use the capacity of internet users in the country and increase the sales rate of agricultural products through the Internet.

Keywords: E-commerce, barriers and challenges, agriculture companies, Afghanistan

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Authors: Payal Maheshwari, Bansari Shah

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The research aimed to study the level of emotional intelligence (EI) and organizational role stress (ORS) of fire-fighters and the relationship between the two variables. Hundred and twenty fire-fighters were selected from different fire stations of Mumbai by purposive sampling. The firefighters who had the basic training, a minimum experience of 2 years and had been on the field during a crisis situation were selected for the study. The firefighters selected ranged from 23-58 years of age, and the number of years of experience ranged from 2 to 33 years. The findings of the study revealed that majority of the firefighters perceived themselves to be at an above average (57) and high (58) level of EI (M=429.35, SD=38.712). Domain-wise analysis disclosed that compared to self-awareness (92) and relationship management (93), more number of participants perceived themselves in the high category in the domains of self-management (108) and social management (106). Further, examination of the subdomain scores conveyed that a large number of participants rated themselves in the average level of these skills of accurate self-assessment (50), emotional self-control (50), adaptability (56) initiative (41), influence (66), change catalyst (53), and conflict management (50). With relation to the stress variable, it was found that almost half the number of the participants (59) rated themselves as having an average level of stress (M=137.44, SD=28.800). In most of the domains, majority of the participants perceived themselves as having an average level of stress, while in the domain of role isolation, self-role distance, and role ambiguity, majority of the firefighters rated themselves as having a low level of stress. A strong negative correlation (r=-.360**, p=.000) was found between EI and ORS. This study is a contribution to the literature and has implications for fire-fighters at the personal level, for the policymakers, and the fire department.

Keywords: emotional intelligence, organizational role stress, firefighters, relationship

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Authors: Natasha Bhate

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Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.

Keywords: barrier, contraception, machismo, religion

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Authors: Nazi Pharsadanishvili, Anastasia Kitiashvili

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The importance of studying the social-psychological features of people living in poverty is often emphasized in international research. Building a multidimensional economic framework for reducing poverty grounded in people’s experiences and values is the main goal of famous Poverty Research Centers (such as Oxford Poverty and Human Development Initiative, Abdul Latif Jameel Poverty Action Lab). The aims of the proposed research are to investigate the following characteristics of socially vulnerable people living in Georgia: 1) The features of the perceived stigma of poverty; 2) economic system justification and social justice beliefs; 3) Perceived social mobility and actual attempts at upward social mobility. Qualitative research was conducted to address the indicated research goals and descriptive research questions. Conducting in-depth interviews was considered to be the most appropriate method to capture the vivid feelings and experiences of people living in poverty. 17 respondents (registered in the unified database of socially vulnerable families) participated in in-depth interviews. According to the research results, socially vulnerable people living in Georgia perceive stigma targeted toward them. Two sub-dimensions were identified in perceived stigma: experienced stigma and internalized stigma. Experienced stigma reflects the instances of being discriminated and perceptions of negative treatment from other members of society. Internalized stigma covers negative personal emotions, the feelings of shame, the fear of future stigmatization, and self-isolation. The attitudes and justifications of the existing economic system affect people’s attempts to cope with poverty. Complex analysis of those results is important during the planning and implementing of social welfare reforms. Particularly, it is important to implement poverty stigma reduction mechanisms and help socially vulnerable people to see real perspectives on upward social mobility.

Keywords: coping with poverty, economic system justification, perceived stigma of poverty, upward social mobility

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Authors: Ridha Abdulla Al Hammam

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Purpose: to measure the extent of perceived structural empowerment and work commitment the intensive care unit in SMC have in their work place. Background: nurses’ access to power structures (information, recourses, opportunity, and support) directly influences their productivity, retention, and job satisfaction. Exploring nurses’ level and sources of work commitment (affective, normative, and continuance) is very essential to guide nursing leaders making decisions to improve work environment to facilitate effective nursing care. Both concepts (Structural Empowerment and Work Commitment) were never investigated in our critical care unit. Methods: a sample of 50 nurses attained from the Intensive Care Unit (Adult). Conditions for Workplace Effectiveness Questionnaire and Three-Component Model Employee Commitment Survey were used to measure the two concepts respectively. The study is quantitative, descriptive, and correlational in design. Results: the participants reported moderate structural empowerment provided by their work place (M=15 out of 20). The sample perceived high access to opportunity mainly through gaining more skills (M=4.45 out of 5) where the rest power structures were perceived with moderate accessibility. The participants’ affective commitment (M=5.6 out of 7) to work in the ICU overweighed their normative and continuance commitment (M=5.1, M=4.9 out of 7) implying a stronger emotional connection with their unit. Strong positive and significant correlations were observed between the participants’ structural empowerment scores and all work commitment sources. Conclusion: these results provided an insight on aspects of work environment that need to be fostered and improved in our intensive care unit which have a direct linkage to nurses’ work commitment and potentially to their quality of care they provide.

Keywords: structural empowerment, commitment, intensive care, nurses

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Authors: Yi-Hsuan Gloria Lo

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The educational objective of vocational high schools (VHSs) is to equip VHS students with practical skills and knowledge that can be applied in the job-related market. However, with the increasing number of technological universities over the past two decades, the majority of VHS students have chosen to receive higher education rather than enter the job market. VHS English education has been confronting a dilemma: Should an English for specific purposes (ESP) approach, which aligns with the educational goal of VHS education, be taken or should an English for general purposes (EGP) approach, which prepares VHS students for advanced studies in universities, be followed? While ESP theorists proposed that that ESP can be taught to secondary learners, little was known about VHS students’ perspective on this ESP-versus-EGP dilemma. Scant research has investigated different facets of students’ needs (necessities, wants, and lacks) for both ESP and EGP in terms of the four language skills and the factors that contribute to any differences. To address the gap in the literature, 100 VHS students responded to statements related to their necessities, wants, and lacks in learning ESP and EGP on a 6-point Likert scale. Six VHS students were interviewed to tap into the reasons for different facets of the needs for learning EGP and ESP. The statistical analysis indicates that at this stage of learning English, VHS subjects believed that EGP was more necessary than ESP; EGP was more desirable than ESP. However, they reported that they were more lacking in ESP than in EGP learning. Regarding EGP, the results show that the VHS subjects rated speaking as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference was found between perceived learning necessities and lacks and between perceived wants and lacks. No statistical difference was found between necessities and wants. In the aspect of ESP, the results indicate that the VHS subjects marked reading as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference exists between their perceived necessities and lacks and between their wants and lacks. However, there is no statistically significant difference between their perceived lacks and wants. Despite the lack of a significant difference between learning necessities and wants, the qualitative interview data reveal that the reasons for their perceived necessities and wants were different. The findings of the study confirm previous research that demonstrates that ‘needs’ is a multiple and conflicting construct. What VHS students felt most lacking was not necessarily what they believed they should learn or would like to learn. Although no statistical difference was found, different reasons were attributed to their perceived necessities and wants. Both theoretical and practical implications have been drawn and discussed for ESP research in general and teaching ESP in VHSs in particular.

Keywords: vocational high schools (VHSs), English for General Purposes (EGP), English for Specific Purposes (ESP), needs analysis

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Authors: Isaac Kofi Mensah, Jianing Mi, Feng Cheng

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This research paper seeks to investigate the factors determining the continuance usage of online mobile payment applications among WECHAT users in China. Technology Acceptance Model (TAM) and the Diffusion of Innovation (DOI) theory would both be applied as the theoretical foundation for this study. A developed instrument would be administered to the targeted sample of 1000 WECHAT Users in the City of Harbin, China, through an online questionnaire administration platform. Factors such as perceived usefulness, perceived ease of use, perceived service quality, social influence, trust in the internet, internet self-efficacy, relative advantage, compatibility, and complexity would be explored to determine its significant impact on the continuance intention to use mobile payment apps. This study is at the development and implementation stage. The successful completion of this research article would not only provide an insightful understanding of the factors influencing the decision of WECHAT users in China to use mobile payment applications but also enrich the e-commerce adoption literature.

Keywords: diffusion of innovation (DOI), e-commerce, mobile payment, technology acceptance model (TAM), WECHAT

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Authors: Ezri Coda, Kris Justine Miparanum, Relvin Jay Sale

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The study dealt on suicide risk level of college students in UM Tagum College. The primary goal of the study was to assess the level of suicide risk among students at the UM Tagum College in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury utilizing quantitative non- experimental study with 380 students in UM Tagum College as respondents of the study. Mean was the statistical tools used for the data treatment. Moreover, the study aims to determine the mean of the level of the suicide risk assessment in terms of program, type of student, age, year level, civil status and gender, and lastly, to design an intervention program for those identified students with high suicide risk. Results showed a low level of suicide risk in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury.

Keywords: suicide risk, perceived burdensomeness, low belongingness/social alienation, acquired ability to enact lethal self-injury, UM Tagum College, Philippines

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Authors: Gezahegn Gizaw

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The FDRE Tourism Training Institute organizes forums for debates, best practices exchange and focus group discussions to forge a sustainable and growing tourism sector while minimizing negative impacts on the environment, communities, and cultures. This study aimed at applying empirical research method to identify and quantify relative importance of success factors and individual engagement indicators that were identified in these forums. Response to the 12-question survey was collected from a total of 437 respondents in academic training institutes (212), business executive and employee (204) and non-academic government offices (21). Overall, capacity building was perceived as the most important driver of success for stakeholder engagement. Business executive and employee category rated capacity building as the most important driver of success (53%), followed by decision-making process (27%) and community participation (20%). Among educators and students, both capacity building and decision-making process were perceived as the most important factors (40% of respondents), whereas community participation was perceived as the most important success factor only by 20% of respondents. Individual engagement score in capacity building, decision-making process and community participation showed highest variability by educational level of participants (variance of 3.4% - 5.2%, p<0.001). Individual engagement score in capacity building was highly correlated to perceived benefit of training on improved efficiency, job security, higher customer satisfaction and self-esteem. On the other hand, individual engagement score in decision making process was highly correlated to its perceived benefit on lowering business costs, improving ability to meet the needs of a target market, job security, self-esteem and more teamwork. The study provides a set of recommendations that help educators, business executives and policy makers to maximize the individual and synergetic effect of training, decision making process on sustainability and growth of the tourism sector in Ethiopia.

Keywords: engagement score, driver of success, capacity building, tourism

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Authors: Yirui Wang

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In the past few decades, patient safety has been the focus of much attention in the global medical and health field. As medical standards continue to improve and develop, the demand for patient safety is also growing. As one of the important dimensions in assessing patient safety, the Patient Perception Patient Safety Assessment Tool provides unique and valuable information from the patient's own perspective and plays an important role in promoting patient safety. This article aims to summarize and analyze the assessment content, assessment methods and applications of currently commonly used patient-perceived patient safety assessment tools at home and abroad, with a view to providing a reference for medical staff to select appropriate patient-perceived patient safety assessment tools.

Keywords: patients, patient safety, perception, assessment tools, review

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Authors: Aziz Zulazmi Samsudin, Siti Norhedayah Abdul Latif

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The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek for help. Stigma surrounding mental health services continue to be the most prevalent barrier for help seeking behavior. Alternative barriers have emerged that are both personal and public in nature that can have a substantial impact on students’ preference to seek for help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with dual education system in exploring both their Self-Stigma of Seeking Help (SSOSH) and Mental Health Help-Seeking Attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomena of help seeking approach by students to understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favorable attitude towards counselling help. There was no significant difference on gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend of relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendation made by students in addressing barriers to counselling and facilitating their counselling needs for the improvement of students' mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped to serve as a guide for policy makers to consider the provision of mental health services that is more appealing to the students’ mental and academic well-being.

Keywords: mental health help-seeking attitude (MHSA), public stigma, school counselling, self-stigma, self-stigma of seeking help (SSOSH), well-being.

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