Search results for: science education

Authors: Enes Huylu, Sude Erkin, Nur A. Özdemir, Hatice K. Güney, Cemre S. Atılgan, Hüseyin Y. Altıntaş, Aysemin Top, Muammer Yılman, Özak Durmuş

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Remanufacturing (reman) applications allow manufacturers to contribute to the circular economy and help to introduce products with almost the same quality, environment-friendly, and lower cost. The objective of this study is to present that the carbon footprint of automotive spare parts used in vehicles could be reduced by reman applications based on Life Cycle Analysis which was framed with ISO 14040 principles. In that case, it was aimed to investigate reman applications for 21 parts in total. So far, research and calculations have been completed for the alternator, turbocharger, starter motor, compressor, manual transmission, auto transmission, and DPF (diesel particulate filter) parts, respectively. Since the aim of Ford Motor Company and Ford OTOSAN is to achieve net zero based on Science-Based Targets (SBT) and the Green Deal that the European Union sets out to make it climate neutral by 2050, the effects of reman applications are researched. In this case, firstly, remanufacturing articles available in the literature were searched based on the yearly high volume of spare parts sold. Paper review results related to their material composition and emissions released during incoming production and remanufacturing phases, the base part has been selected to take it as a reference. Then, the data of the selected base part from the research are used to make an approximate estimation of the carbon footprint reduction of the relevant part used in Ford OTOSAN. The estimation model is based on the weight, and material composition of the referenced paper reman activity. As a result of this study, it was seen that remanufacturing applications are feasible to apply technically and environmentally since it has significant effects on reducing the emissions released during the production phase of the vehicle components. For this reason, the research and calculations of the total number of targeted products in yearly volume have been completed to a large extent. Thus, based on the targeted parts whose research has been completed, in line with the net zero targets of Ford Motor Company and Ford OTOSAN by 2050, if remanufacturing applications are preferred instead of recent production methods, it is possible to reduce a significant amount of the associated greenhouse gas (GHG) emissions of spare parts used in vehicles. Besides, it is observed that remanufacturing helps to reduce the waste stream and causes less pollution than making products from raw materials by reusing the automotive components.

Keywords: greenhouse gas emissions, net zero targets, remanufacturing, spare parts, sustainability

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Authors: Enes Caliskan, Hatice Camgoz Akdag

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There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Agata Chudzicka-Czupała, Nadiya Hapon, Liudmyla Karamushka, Marta żywiołek-Szeja

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Objectives: The study is about the determinants of coping with stress connected with volunteer activity for Russo-Ukrainian war 2022 refugees. We examined the mental health reactions, chosen psychological traits, and motivational functions of volunteers working in Poland and Ukraine in relation to their coping with stress styles. The study was financed with funds from the Foundation for Polish Science in the framework of the FOR UKRAINE Programme. Material and Method: The study was conducted in 2022. The study was a quantitative, questionnaire-based survey. Data was collected through an online survey. The volunteers were asked to assess their propensity to use different styles of coping with stress connected with their activity for Russo-Ukrainian war refugees using The Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) questionnaire. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale. Chosen psychological traits, psychological capital and hardiness, were assessed by The Psychological Capital Questionnaire and The Norwegian Revised Scale of Hardiness (DRS-15R). Then The Volunteer Function Inventory (VFI) was used. The significance of differences between the variable means of the samples was tested by the Student's t-test. We used multivariate linear regression to identify factors associated with coping with stress styles separately for each national sample. Results: The sample consisted of 720 volunteers helping war refugees (in Poland, 435 people, and 285 in Ukraine). The results of the regression analysis indicate variables that are significant predictors of the propensity to use particular styles of coping with stress (problem-focused style, emotion-focused style and avoidant coping). These include levels of depression and stress, individual psychological characteristics and motivational functions, different for Polish and Ukrainians. Ukrainian volunteers are significantly more likely to use all three coping with stress styles than Polish ones. The results also prove significant differences in the severity of anxiety, stress and depression, the selected psychological traits and motivational functions studied, which led volunteers to participate in activities for war refugees. Conclusions: The results show that depression and stress severity, as well as psychological capital and hardiness, and motivational factors are connected with coping with stress behavior. The results indicate the need for increased attention to the well-being of volunteers acting under stressful conditions. They also prove the necessity of guiding the selection of people for specific types of volu

Keywords: anxiety, coping with stress styles, depression, hardiness, mental health, motivational functions, psychological capital, resilience, stress, war, volunteer, civil society

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Authors: Zahidul Islam

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This study investigates the effectiveness of resourcing in post-disaster housing reconstruction with reference to Cyclones Sidr and Aila in Bangladesh. Through evaluating three key theories- Build Back Better approach, Balance Scorecard approach and Dynamic Competency theories, the synthesis of literature, and empirical fieldwork, this research develops a dynamic theoretical framework that moves the trajectory of post-disaster housing reconstruction towards the reconstruction of more resilient houses. The ultimate goal of any post-disaster housing reconstruction project is to provide quality houses and to achieve high levels of satisfaction for beneficiaries. However, post-disaster reconstruction projects often fail in their stated objectives; only 10-20% housing needs are met, with most houses constructed on a temporary rather than permanent basis. A number of scholars have argued that access to resources can significantly increase the capacity and capability of disaster victims to rebuild their lives, including the construction of new homes. This study draws on structured interviews of 285 villagers affected by cyclones to investigate the effectiveness of resourcing in rebuilding houses after Cyclone Sidr in 2007 and Cyclone Aila in 2009. Furthermore, semi-structured interviews were conducted with 20 key stakeholders in UNDP, Oxfam, government officials, and national and international NGOs. The results of this study show that recovery rate of cyclone resilient houses that can withstand cyclone is very low and majority of the population are still vulnerable. Furthermore, hierarchical regression of survey data and thematic analyses of qualitative data indicate that access to resources, level of education, quality of building materials and income generating activities of the respondents are critical for effective post-disaster recovery. Conversely, resource availability, lack of coordination among participant organisations, corruption and lack of access to appropriate land constituted significant obstacles to livelihood recovery. Finally, this study makes significant theoretical contributions to theories of post-disaster recovery by introducing new variables and measures for evaluating the quality and effectiveness of post-disaster housing.

Keywords: disaster, resourcing, housing, resilience

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Limited research has examined the variations in dietary quality among U.S. adults diagnosed with chronic conditions like diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA), particularly across different age groups. Understanding how diet differs in relation to these conditions is crucial to developing targeted nutritional interventions. This cross-sectional study analyzed data from adult participants in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2021. Dietary quality was measured using the Healthy Eating Index (HEI)-2015 scores, encompassing both total and component scores for different dietary factors. Self-reported disease statuses for DM, OA, and RA were obtained, with age groups stratified into younger adults (20–59 years, n = 10,050) and older adults (60 years and older, n = 5,200). Logistic regression models, adjusted for demographic factors like sex, race/ethnicity, education, income, weight status, physical activity, and smoking, were used to examine the relationship between disease status and dietary quality, accounting for NHANES' complex survey design. Among younger adults, 8% had DM, 10% had OA, and 4% had RA. Among older adults, 22% had DM, 35% had OA, and 7% had RA. The results showed a consistent association between excess added sugar intake and DM in both age groups. In younger adults, excess sodium intake was also linked to DM, while low seafood and plant protein intake was associated with a higher prevalence of RA. Among older adults, a poor overall dietary pattern was strongly associated with RA, while OA showed varying associations depending on the intake of specific nutrients like fiber and saturated fats. The dietary quality of U.S. adults with DM, OA, and RA varies significantly by age group and disease type. Younger adults with these conditions demonstrated more specific dietary inadequacies, such as high sodium and low protein intake, while older adults exhibited a broader pattern of poor dietary quality, particularly in relation to RA. These findings suggest that personalized nutritional strategies are needed to address the unique dietary challenges faced by individuals with chronic conditions in different age groups.

Keywords: dietary, diabetes, osteoarthritis, rheumatoid arthritis, logistic regression

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Authors: E. H. Walsh, J. McMahon, M. P. Herring

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Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

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Authors: Fonteyne Lot

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SIMON (Study capacities and Interest Monitor is a freely accessible online self-assessment tool that allows secondary education pupils to evaluate their interests and capacities in order to choose a post-secondary major that maximally suits their potential. The tool consists of two broad domains that correspond with two general questions pupils ask: 'What study fields interest me?' and 'Am I capable to succeed in this field of study?'. The first question is addressed by a RIASEC-type interest inventory that links personal interests to post-secondary majors. Pupils are provided with a personal profile and an overview of majors with their degree of congruence. The output is dynamic: respondents can manipulate their score and they can compare their results to the profile of all fields of study. That way they are stimulated to explore the broad range of majors. To answer whether pupils are capable of succeeding in a preferred major, a battery of tests is provided. This battery comprises a range of factors that are predictive of academic success. Traditional predictors such as (educational) background and cognitive variables (mathematical and verbal skills) are included. Moreover, non-cognitive predictors of academic success (such as 'motivation', 'test anxiety', 'academic self-efficacy' and 'study skills') are assessed. These non-cognitive factors are generally not included in admission decisions although research shows they are incrementally predictive of success and are less discriminating. These tests inform pupils on potential causes of success and failure. More important, pupils receive their personal chances of success per major. These differential probabilities are validated through the underlying research on academic success of students. For example, the research has shown that we can identify 22 % of the failing students in psychology and educational sciences. In this group, our prediction is 95% accurate. SIMON leads more students to a suitable major which in turn alleviates student success and retention. Apart from these benefits, the instrument grants insight into risk factors of academic failure. It also supports and fosters the development of evidence-based remedial interventions and therefore gives way to a more efficient use of means.

Keywords: academic success, online self-assessment, student retention, vocational choice

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Authors: Sabli, Eddy Rismunandar, Akhirudin, Nana Halim, Zulfikar, Nining Dwirosanti, Wila Ningsih, Pipih Siti Sofiah, Danik Dania Asadayanti, Dewi Eka Arini Algozi, Gita Mahardika Pamuji, Ajun, Mangasa Aritonang, Nanang Rukmana, Arief Rachman Wonodhipo, Victor Imanuel Nahumury, Lili Husada, Wawan Saepul Irwan, Al Mukhlas Fikri

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Covid-19 pandemic has widely impacted the lives. An adaptive strategy must be quickly formulated to maintain the quality of education, especially by vocational school which technical skill competencies are highly needed. This study aimed to evaluate the effectiveness of e-training on the attitude and skill competencies of vocational high school teachers in Indonesia. A total of 720 Indonesian vocational high school teachers with various programs, including hospitality, administration, online business and marketing, culinary arts, fashion, cashier, tourism, haircut, and accounting participated e-training for a month. The training used electronic learning management system to provide materials (modules, presentation slides, and tutorial videos), tasks, and evaluations. Tutorial class was carried out by video conference meeting. Attitude and skill competencies were evaluated before and after the training. Meanwhile, the teachers also gave satisfactory feedback on the quality of the organizer and tutors. Data analysis used paired sample t-test and Anova with Tukey’s post hoc test. The results showed that e-training significantly increased the score of attitude and skill competencies of the teachers (p <0,05). Moreover, the remarkable increase was found among hospitality (57,5%), cashier (50,1%), and online business and marketing (48,7%) teachers. However, the effect among fashion, tourism and haircut teachers was less obvious. In addition, the satisfactory score on the quality of the organizer and tutors were 88,9 (very good), and 93,5 (excellence), respectively. The study concludes that a well-organized e-training could increase the attitude and skill competencies of Indonesian vocational high school teachers during Covid-19 pandemic.

Keywords: E-training, skill, teacher, vocational high school

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Authors: Abram Zoltan

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Over the past hundred years, human activities, particularly the burning of fossil fuels, have released enough carbon dioxide and other greenhouse gases to dissipate additional heat into the lower atmosphere and affect the global climate. Climate change affects many social and environmental determinants of health: clean air, safe drinking water, and adequate food. Our aim is to draw attention to the effects of climate change on the health and health care system. Improving climate awareness and the knowledge related to climate change's health impacts are essential among medical students and practicing medical doctors. Therefore, in their everyday practice, they also need some assistance and up-to-date knowledge of how climate change can endanger human health and deal with these novel health problems. Our activity, based on the cooperation of more universities, aims to develop new curriculum outlines and learning materials on climate change's health impacts for medical schools. Special attention is intended to pay to the possible preventative measures against these impacts. For all of this, the project plans to create new curriculum outlines and learning materials for medical students, elaborate methodological guidelines and create training materials for medical doctors' postgraduate learning programs. The target groups of the project are medical students, educational staff of medical schools and universities, practicing medical doctors with special attention to the general practitioners and family doctors. We had searched various surveys, domestic and international studies about the effects of climate change and statistical estimation of the possible consequences. The health effects of climate change can be measured only approximately by considering only a fraction of the potential health effects and assuming continued economic growth and health progress. We can estimate that climate change is expected to cause about 250,000 more deaths. We conclude that climate change is one of the most serious problems of the 21st century, affecting all populations. In the short- to medium-term, the health effects of climate change will be determined mainly by human vulnerability. In the longer term, the effects depend increasingly on the extent to which transformational action is taken now to reduce emissions. We can contribute to reducing environmental pollution by raising awareness and by educating the population.

Keywords: climate change, health impacts, medical students, education

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Authors: Mariam Shalaby, Kayla Krause, Raisha Ismail, Daniel George

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Introduction: The Pennsylvania State College of Medicine Refugee Initiative is a student-run organization that works with eleven Syrian and Congolese refugee families. Since 2016, it has used grant funding to make weekly produce purchases at a local market, provide tutoring services, and develop trusting relationships. This case study explains how the Refugee Initiative shifted focus to face new challenges due to the COVID-19 pandemic in 2020. Methodology: When refugees who had previously attained stability found themselves unable to pay the bills, the organization shifted focus from food security to direct assistance such as applying for unemployment compensation since many had recently lost jobs. When refugee families additionally struggled to access hygiene supplies, funding was redirected to purchase them. Funds were also raised from the community to provide financial relief from unpaid rent and bills. Findings: Systemic challenges were encountered in navigating federal/state unemployment and social welfare systems, and there was a conspicuous absence of affordable, language-accessible assistance that could help refugees. Finally, as struggling public schools failed to maintain adequate English as a Second Language (ESL) education, the group’s tutoring services were hindered by social distancing and inconsistent access to distance-learning platforms. Conclusion: Ultimately, the pandemic highlighted that a charity-based arrangement is helpful but not sustainable, and challenges persist for refugee families. Based on the Refugee Initiative's experiences over the past year of the COVID-19 pandemic, several needs must be addressed to aid refugee families at this time, including: increased access to affordable and language-accessible social services, educational resources, and simpler options for grant-based financial assistance. Interventions to increase these resources will aid refugee families in need in Central Pennsylvania and internationally

Keywords: COVID-19, health, pandemic, refugees

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Authors: Kamila Widziewicz-Rzonca

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The presence of PM bound water as an integral chemical compound of suspended aerosol particles (PM) has become one of the hottest issues in recent years. The UN climate summits on climate change (COP24) indicate that PM of anthropogenic origin (released mostly from coal combustion) is directly responsible for climate change. Chemical changes at the particle-liquid (water) interface determine many phenomena occurring in the atmosphere such as visibility, cloud formation or precipitation intensity. Since water-soluble particles such as nitrates, sulfates, or sea salt easily become cloud condensation nuclei, they affect the climate for example by increasing cloud droplet concentration. Aerosol water is a master component of atmospheric aerosols and a medium that enables all aqueous-phase reactions occurring in the atmosphere. Thanks to a thorough bibliometric analysis conducted using CiteSpace Software, it was possible to identify past trends and possible future directions in measuring aerosol-bound water. This work, in fact, doesn’t aim at reviewing the existing literature in the related topic but is an in-depth bibliometric analysis exploring existing gaps and new frontiers in the topic of PM-bound water. To assess the major scientific areas related to PM-bound water and clearly define which among those are the most active topics we checked Web of Science databases from 1996 till 2018. We give an answer to the questions: which authors, countries, institutions and aerosol journals to the greatest degree influenced PM-bound water research? Obtained results indicate that the paper with the greatest citation burst was Tang In and Munklewitz H.R. 'water activities, densities, and refractive indices of aqueous sulfates and sodium nitrate droplets of atmospheric importance', 1994. The largest number of articles in this specific field was published in atmospheric chemistry and physics. An absolute leader in the quantity of publications among all research institutions is the National Aeronautics Space Administration (NASA). Meteorology and atmospheric sciences is a category with the most studies in this field. A very small number of studies on PM-bound water conduct a quantitative measurement of its presence in ambient particles or its origin. Most articles rather point PM-bound water as an artifact in organic carbon and ions measurements without any chemical analysis of its contents. This scientometric study presents the current and most actual literature regarding particulate bound water.

Keywords: systematic review, aerosol-bound water, PM-bound water, CiteSpace, knowledge domain

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Authors: R. Khare, R. V. Gelamo, M. A. More, D. J. Late, Chandra Sekhar Rout

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Graphene emerges out as a promising material for various applications ranging from complementary integrated circuits to optically transparent electrode for displays and sensors. The excellent conductivity and atomic sharp edges of unique two-dimensional structure makes graphene a propitious field emitter. Graphene analogues of other 2D layered materials have emerged in material science and nanotechnology due to the enriched physics and novel enhanced properties they present. There are several advantages of using 2D nanomaterials in field emission based devices, including a thickness of only a few atomic layers, high aspect ratio (the ratio of lateral size to sheet thickness), excellent electrical properties, extraordinary mechanical strength and ease of synthesis. Furthermore, the presence of edges can enhance the tunneling probability for the electrons in layered nanomaterials similar to that seen in nanotubes. Here we report electron emission properties of multilayer graphene and effect of plasma (CO2, O2, Ar and N2) treatment. The plasma treated multilayer graphene shows an enhanced field emission behavior with a low turn on field of 0.18 V/μm and high emission current density of 1.89 mA/cm2 at an applied field of 0.35 V/μm. Further, we report the field emission studies of layered WS2/RGO and SnS2/RGO composites. The turn on field required to draw a field emission current density of 1μA/cm2 is found to be 3.5, 2.3 and 2 V/μm for WS2, RGO and the WS2/RGO composite respectively. The enhanced field emission behavior observed for the WS2/RGO nanocomposite is attributed to a high field enhancement factor of 2978, which is associated with the surface protrusions of the single-to-few layer thick sheets of the nanocomposite. The highest current density of ~800 µA/cm2 is drawn at an applied field of 4.1 V/μm from a few layers of the WS2/RGO nanocomposite. Furthermore, first-principles density functional calculations suggest that the enhanced field emission may also be due to an overlap of the electronic structures of WS2 and RGO, where graphene-like states are dumped in the region of the WS2 fundamental gap. Similarly, the turn on field required to draw an emission current density of 1µA/cm2 is significantly low (almost half the value) for the SnS2/RGO nanocomposite (2.65 V/µm) compared to pristine SnS2 (4.8 V/µm) nanosheets. The field enhancement factor β (~3200 for SnS2 and ~3700 for SnS2/RGO composite) was calculated from Fowler-Nordheim (FN) plots and indicates emission from the nanometric geometry of the emitter. The field emission current versus time plot shows overall good emission stability for the SnS2/RGO emitter. The DFT calculations reveal that the enhanced field emission properties of SnS2/RGO composites are because of a substantial lowering of work function of SnS2 when supported by graphene, which is in response to p-type doping of the graphene substrate. Graphene and 2D analogue materials emerge as a potential candidate for future field emission applications.

Keywords: graphene, layered material, field emission, plasma, doping

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Authors: Larissa Pliska, Isabel Neitzel, Michael Buschermöhle, Olga Kunina-Habenicht, Ute Ritterfeld

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Visual preferences, which can be assessed using eye tracking technologies, are considered one of the defining hallmarks of Autism Spectrum Disorder (ASD). Specifically, children with ASD show a decreased preference for social images rather than geometric images compared to typically developed (TD) children. Such differences are already prevalent at a very early age and indicate the severity of the disorder: toddlers with ASD who preferred geometric images when confronted with social and geometric images showed higher ASD symptom severity than toddlers with ASD who showed higher social attention. Furthermore, the complexity of social pictures (one child playing vs. two children playing together) as well as the mode of stimulus presentation (video or image), are not decisive for the marker. The average age of diagnosis for ASD in Germany is 6.5 years, and visual preference data on this age group is missing. In the present study, we therefore investigated whether visual preferences persist into school age. We examined the visual preferences of 16 boys aged 6 to 11 with ASD and unimpaired cognition as well as TD children (1:1 matching based on children's age and the parent's level of education) within an experimental setting. Different stimulus presentation formats (images vs. videos) and different levels of stimulus complexity were included. Children with and without ASD received pairs of social and non-social images and video stimuli on a screen while eye movements (i.e., eye position and gaze direction) were recorded. For this specific use case, KIZMO GmbH developed a customized, native iOS app (KIZMO Face-Analyzer) for use on iPads. Neither the format of stimulus presentation nor the complexity of the social images had a significant effect on the visual preference of children with and without ASD in this study. Despite the tendency for a difference between the groups for the video stimuli, there were no significant differences. Overall, no statistical differences in visual preference occurred between boys with and without ASD, suggesting that gaze preference in these groups is similar at primary school age. One limitation is that the children with ASD were already receiving Autism-specific intervention. The potential of a visual preference task as an indicator of ASD can be emphasized. The article discusses the clinical relevance of this marker in elementary school children.

Keywords: autism spectrum disorder, eye tracking, hallmark, visual preference

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Authors: Josée Charette

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The academic and educational success of immigrant students is a current issue in education, especially in western societies such in the province of Quebec, in Canada. For people who immigrate with school-age children, the success of the family’s migratory project is often measured by the benefits drawn by children from the educational institutions of their host society. In order to support the academic achievement of their children, immigrant parents try to develop practices that derive from their representations of school and related challenges inspired by the socio-cultural context of their country of origin. These findings lead us to the following question: How does strategies implemented by immigrant parents to manage the representational distance between school of their country of origin and school of the host society support or not the academic and educational success of their child? In the context of a qualitative exploratory approach, we have made interviews in the French-, English- and Spanish-languages with 32 newly immigrated parents and 10 of their children. Parents were invited to complete a network of free associations about «School in Quebec» as a premise for the interview. The objective of this communication is to present strategies implemented by immigrant parents to manage the distance between their representations of schools in their country of origin and in the host society, and to explore the influence of this management on their child’s academic and educational trajectories. Data analysis led us to develop various types of strategies, such as continuity, adaptation, resources mobilization, compensation and "return to basics" strategies. These strategies seem to be part of a continuum from oppositional-conflict scenario, in which parental strategies act as a risk factor, to conciliator-integrator scenario, in which parental strategies act as a protective factor for immigrant students’ academic and educational success. In conclusion, we believe that our research helps in providing a more efficient support to immigrant parents and contributes to develop a wider portrait of immigrant students’ academic achievement. In addition, we think that by improving the experience of immigrant families in Quebec schools, a greater number of migratory projects will be effective.

Keywords: immigrant students, family’s migratory project, school of origin and school of host society, immigrants parental strategies

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Authors: Md. Ashikur Rahman

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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.

Keywords: exclusive, breast feeding, practices, Bangladesh

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Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: David Tennison

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In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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Authors: Burhan Khan

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Objective: This study aims to enhance the body of knowledge about the vulnerabilities of child waste pickers in solid waste management. The primary objective of this research is to investigate the occupational menaces and their potential harm to the health of child waste pickers. Material and Methods: The present study design is descriptive in nature and involves children aged 5 through 14, who were rummaging through garbage in the roads and streets of Aligarh city, Uttar Pradesh. The researcher adopted an empirical approach to interview 65 participants (27 boys and 38 girls) across Aligarh city, Uttar Pradesh. The majority of the participants are Muslims (76.9 %), scheduled Castes (13.8 %), and Hindus (9.2 %). Out of 65 participants, 73.8% of children were migrated within the last five years. The primary data were analysed by utilising descriptive statistics, including frequencies, cross-tabs, means, and percentages. Results: The results show that the vast majority of children (87.7%) have experienced superficial injuries or open wound at their work. More than 32% were suffering from respiratory problems such as coughing, wheezing and short of breath, close to 37% reported skin problems like allergy, irritation and bruising and 4.6% had eye problems such as pain and irritation in eyes. Nearly 78% of children lift and carry a heavy load like large garbage bags. Over 83% informed that they sort through refuse in a filthy environment such as open dumpsites, effluents, and runnels. Conclusion: This research provides pieces of evidence of how children are being tormented in the rag-picking sector. It has been observed that child rag pickers are susceptible to injuries or illnesses due to work-related risks and toxic environment. In India, there is no robust policy to address the concerns of waste pickers and laws to protect their rights. Consequently, these deprived communities of rag pickers, especially children, have become more vulnerable over time in India. Hence, this research paper calls for a quick response to the exigencies of child rag picker by developing a holistic approach that deals with education, medical care, sanitation, and nutrition for child rag pickers.

Keywords: child rag pickers, health impairments, occupational hazards, toxic environment

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Authors: Ann Devitt, Mairead Brady, Markus Lamest, Stephen Gomez

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This study set out to explore the use of an online collaborative serious game for student learning in a postgraduate introductory marketing module. The simulation game aimed to bridge the theory-practice divide in marketing by allowing students to apply theory in a safe, simulated marketplace. This study addresses the following research questions: Does an online marketing simulation game engage students higher order cognitive skills? Does collaborative activity required develop students’ “soft” skills, such as communication and negotiation? What specific affordances of the online simulation promote learning? This qualitative case study took place in 2014 with 40 postgraduate students on a Business Masters Programme. The two-week intensive module combined lectures with collaborative activity on a marketing simulation game, MMX from Pearsons. The game requires student teams to compete against other teams in a marketplace and design a marketing plan to maximize key performance indicators. The data for this study comprise essays written by students after the module reflecting on their learning on the module. A thematic analysis was conducted of the essays using the following a priori theme sets: 6 levels of the cognitive domain of Blooms taxonomy; 5 principles of Cooperative Learning; affordances of simulation environments including experiential learning; motivation and engagement; goal orientation. Preliminary findings would strongly suggest that the game facilitated students identifying the value of theory in practice, in particular for future employment; enhanced their understanding of group dynamics and their role within that; and impacted very strongly, both positively and negatively on motivation. In particular the game mechanics of MMX, which hinges on the correct identification of a target consumer group, was identified as a key determinant of extrinsic and intrinsic motivation for learners. The findings also suggest that the situation of the simulation game within a broader module which required post-game reflection was valuable in identifying key learning of marketing concepts in both the positive and the negative experiences of the game.

Keywords: simulation, marketing, serious game, cooperative learning, bloom's taxonomy

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Authors: Ruwani N. Nugara, Masashi Inafuku, Kensaku Takara, Hironori Iwasaki, Hirosuke Oku

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Pteryxin from the partially purified hexane phase (HP) of Peucedanum japonicum Thunb (PJT) was identified as the active compound related to anti-obesity. Thus, in this study we investigated the mechanisms related to anti-obesity activity in-vitro. The HP was fractionated, and effect on the triglyceride (TG) content was evaluated in 3T3-L1 and HepG2 cells. Comprehensive spectroscopic analyses were used to identify the structure of the active compound. The dose dependent effect of active constituent on the TG content, and the gene expressions related to adipogenesis, fatty acid catabolism, energy expenditure, lipolysis and lipogenesis (20 μg/mL) were examined in-vitro. Furthermore, higher dosage of pteryxin (50μg/mL) was tested against 20μg/mL in 3T3-L1 adipocytes. The mRNA were subjected to SOLiD next generation sequencer and the obtained data were analyzed by Ingenuity Pathway Analysis (IPA). The active constituent was identified as pteryxin, a known compound in PJT. However, its biological activities against obesity have not been reported previously. Pteryxin dose dependently suppressed TG content in both 3T3-L1 adipocytes and HepG2 hepatocytes (P < 0.05). Sterol regulatory element-binding protein-1 (SREBP1 c), Fatty acid synthase (FASN), and acetyl-CoA carboxylase-1 (ACC1) were downregulated in pteryxin-treated adipocytes (by 18.0, 36.1 and 38.2%; P < 0.05, respectively) and hepatocytes (by 72.3, 62.9 and 38.8%, respectively; P < 0.05) indicating its suppressive effects on fatty acid synthesis. The hormone-sensitive lipase (HSL), a lipid catabolising gene was upregulated (by 15.1%; P < 0.05) in pteryxin-treated adipocytes suggesting improved lipolysis. Concordantly, the adipocyte size marker gene, paternally expressed gene1/mesoderm specific transcript (MEST) was downregulated (by 42.8%; P < 0.05), further accelerating the lipolytic activity. The upregulated trend of uncoupling protein 2 (UCP2; by 77.5%; P < 0.05) reflected the improved energy expenditure due to pteryxin. The 50μg/mL dosage of pteryxin completely suppressed PPARγ, MEST, SREBP 1C, HSL, Adiponectin, Fatty Acid Binding Protein (FABP) 4, and UCP’s in 3T3-L1 adipocytes. The IPA suggested that pteryxin at 20μg/mL and 50μg/mL suppress obesity in two different pathways, whereas the WNT signaling pathway play a key role in the higher dose of pteryxin in preadipocyte stage. Pteryxin in PJT play the key role in regulating lipid metabolism related gene network and improving energy production in vitro. Thus, the results suggests pteryxin as a new natural compound to be used as an anti-obesity drug in pharmaceutical industry.

Keywords: obesity, peucedanum japonicum thunb, pteryxin, food science

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Authors: Twinkle Sara Joseph

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Virtual reality technology has emerged as a revolutionary power that can transform the education sector in many ways. VR environments can break the boundaries of the traditional classroom setting by immersing the students in realistic 3D environments where they can interact with virtual characters without fearing being judged. Communication skills are essential for every profession, and studies suggest the importance of implementing basic-level communication courses at both the school and graduate levels. Interpersonal communication is a skill that gains prominence as it is required in every profession. Traditional means of training have limitations for trainees as well as participants. The fear of being judged, the audience interaction, and other factors can affect the performance of a participant in a traditional classroom setting. Virtual reality offers a unique opportunity for its users to participate in training that does not set any boundaries that prevent the participants from performing in front of an audience. Specialised applications designed in VR headsets offer a range of training and exercises for participants without any time, space, or audience limitations. The present study aims at measuring the effectiveness of VR training in improving interpersonal communication skills among students. The study uses a mixed-method approach, in which a pre-and post-test will be designed to measure effectiveness. A preliminary selection process involving a questionnaire and a screening test will identify suitable candidates based on their current communication proficiency levels. Participants will undergo specialised training through the VR application Virtual Speech tailored for interpersonal communication and public speaking, designed to operate without the traditional constraints of time, space, or audience. The training's impact will subsequently be measured through situational exercises to engage the participants in interpersonal communication tasks, thereby assessing the improvement in their skills. The significance of this study lies in its potential to provide empirical evidence supporting VR technology's role in enhancing communication skills, thereby offering valuable insights for integrating VR-based methodologies into educational frameworks to prepare students more effectively for their professional futures.

Keywords: virtual reality, VR training, interpersonal communication, communication skills, 3D environments

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Authors: A. Degale Desta, Tamirat Kebamo

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Background: Recent advances in computer vision and pattern recognition have significantly improved activity recognition through video analysis, particularly with the application of Deep Convolutional Neural Networks (CNNs). One-stage detectors now enable efficient video-based recognition by simultaneously predicting object categories and locations. Such advancements are highly relevant in educational settings where CCTV surveillance could automatically monitor academic activities, enhancing security and classroom management. However, current datasets and recognition systems lack the specific focus on campus environments necessary for practical application in these settings.Objective: This study aims to address this gap by developing a dataset and testing an automated activity recognition system specifically tailored for educational campuses. The EthioCAD dataset was created to capture various classroom activities and teacher-student interactions, facilitating reliable recognition of academic activities using deep learning models. Method: EthioCAD, a novel video-based dataset, was created with a design science research approach to encompass teacher-student interactions across three domains and 18 distinct classroom activities. Using the Roboflow AI framework, the data was processed, with 4.224 KB of frames and 33.485 MB of images managed for frame extraction, labeling, and organization. The Ultralytics YOLOv8 model was then implemented within Google Colab to evaluate the dataset’s effectiveness, achieving high mean Average Precision (mAP) scores. Results: The YOLOv8 model demonstrated robust activity recognition within campus-like settings, achieving an mAP50 of 90.2% and an mAP50-95 of 78.6%. These results highlight the potential of EthioCAD, combined with YOLOv8, to provide reliable detection and classification of classroom activities, supporting automated surveillance needs on educational campuses. Discussion: The high performance of YOLOv8 on the EthioCAD dataset suggests that automated activity recognition for surveillance is feasible within educational environments. This system addresses current limitations in campus-specific data and tools, offering a tailored solution for academic monitoring that could enhance the effectiveness of CCTV systems in these settings. Conclusion: The EthioCAD dataset, alongside the YOLOv8 model, provides a promising framework for automated campus activity recognition. This approach lays the groundwork for future advancements in CCTV-based educational surveillance systems, enabling more refined and reliable monitoring of classroom activities.

Keywords: deep CNN, EthioCAD, deep learning, YOLOv8, activity recognition

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Authors: Sulemana Saibu, Moses Ikpeme

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Background: The severity of the COVID-19 pandemic, brought on by the SARS-CoV-2 coronavirus, has been unprecedented since the 1918 influenza pandemic. SARS-CoV-2 cases of CNS and peripheral nervous system disease, including neurodegenerative disorders and chronic immune-mediated diseases, may be anticipated based on knowledge of past coronaviruses, particularly those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks. Although respiratory symptoms are the most common clinical presentation, neurological symptoms are becoming increasingly recognized, raising concerns about their potential role in causing Parkinson's disease, Multiple sclerosis, and Narcolepsy. This systematic review aims to summarize the current evidence by exploring the association between COVID-19 infection and how it may overlap with etiological mechanisms resulting in Narcolepsy, Parkinson's disease, and Multiple sclerosis. Methods: A systematic search was conducted using electronic databases ((PubMed/MedLine, Embase, PsycINFO, ScieLO, Web of Science, ProQuest (Biotechnology, Virology, and AIDS), Scopus, and CINAHL)) to identify studies published between January 2020 and December 2022 that investigated the association between COVID-19 and Parkinson's disease, multiple sclerosis, and Narcolepsy. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was performed and reported. Study quality was assessed using the Critical Appraisal Skills Programme Checklist and the Joanna Briggs Institute Critical appraisal tools. Results: A total of 21 studies out of 1025 met the inclusion criteria, including 8 studies reporting Parkinson's disease, 11 on multiple sclerosis, and 2 on Narcolepsy. In COVID-19 individuals compared to the general population, Narcolepsy, Parkinson's disease, and multiple sclerosis were shown to have a higher incidence. The findings imply that COVID-19 may worsen the signs or induce multiple sclerosis and Parkinson's disease and may raise the risk of developing Narcolepsy. Further research is required to confirm these connections because the available data is insufficient. Conclusion: According to the existing data, COVID-19 may raise the risk of Narcolepsy and have a causative relationship with Parkinson's disease, multiple sclerosis, and other diseases. More study is required to confirm these correlations and pinpoint probable mechanisms behind these interactions. Clinicians should be aware of how COVID-19 may affect various neurological illnesses and should treat patients who are affected accordingly.

Keywords: COVID-19, parkinson’s disease, multiple sclerosis, narcolepsy, neurological disorders, sars-cov-2, neurodegenerative disorders, chronic immune-mediated diseases

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Authors: Tanja Ecken, Laura Fricke, Anika Wehling, Maren M. Michaelsen, Tobias Esch

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Studies and applied experiences evidence severe and traumatic accidents not only require physical rehabilitation and recovery but also necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived everyday nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be a spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: post traumatic growth, happiness, life satisfaction, traumatic life events, paraplegia, ABC model, trauma

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Authors: M. Qamarul Islam, Ergun Dogan, Mehmet Yazici

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There is a growing body of evidence that non-normal data is more prevalent in nature than the normal one. Examples can be quoted from, but not restricted to, the areas of Economics, Finance and Actuarial Science. The non-normality considered here is expressed in terms of fat-tailedness and asymmetry of the relevant distribution. In this study a skew t distribution that can be used to model a data that exhibit inherent non-normal behavior is considered. This distribution has tails fatter than a normal distribution and it also exhibits skewness. Although maximum likelihood estimates can be obtained by solving iteratively the likelihood equations that are non-linear in form, this can be problematic in terms of convergence and in many other respects as well. Therefore, it is preferred to use the method of modified maximum likelihood in which the likelihood estimates are derived by expressing the intractable non-linear likelihood equations in terms of standardized ordered variates and replacing the intractable terms by their linear approximations obtained from the first two terms of a Taylor series expansion about the quantiles of the distribution. These estimates, called modified maximum likelihood estimates, are obtained in closed form. Hence, they are easy to compute and to manipulate analytically. In fact the modified maximum likelihood estimates are equivalent to maximum likelihood estimates, asymptotically. Even in small samples the modified maximum likelihood estimates are found to be approximately the same as maximum likelihood estimates that are obtained iteratively. It is shown in this study that the modified maximum likelihood estimates are not only unbiased but substantially more efficient than the commonly used moment estimates or the least square estimates that are known to be biased and inefficient in such cases. Furthermore, in conventional regression analysis, it is assumed that the error terms are distributed normally and, hence, the well-known least square method is considered to be a suitable and preferred method for making the relevant statistical inferences. However, a number of empirical researches have shown that non-normal errors are more prevalent. Even transforming and/or filtering techniques may not produce normally distributed residuals. Here, a study is done for multiple linear regression models with random error having non-normal pattern. Through an extensive simulation it is shown that the modified maximum likelihood estimates of regression parameters are plausibly robust to the distributional assumptions and to various data anomalies as compared to the widely used least square estimates. Relevant tests of hypothesis are developed and are explored for desirable properties in terms of their size and power. The tests based upon modified maximum likelihood estimates are found to be substantially more powerful than the tests based upon least square estimates. Several examples are provided from the areas of Economics and Finance where such distributions are interpretable in terms of efficient market hypothesis with respect to asset pricing, portfolio selection, risk measurement and capital allocation, etc.

Keywords: least square estimates, linear regression, maximum likelihood estimates, modified maximum likelihood method, non-normality, robustness

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Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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Authors: Elham Falatoonitoosi, Vikki Schaffer, Don Kerr

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Over-development for tourism and its consequences on residents’ well-being turn into a critical issue in tourism destinations. Learning about undesirable impacts of tourism has led many people to seek more sustainable and responsible tourism. The main objective of this research is to understand how and to what extent sustainable tourism development enhances locals’ well-being regarding stakeholder perception. The research was conducted in a coastal-hinterland tourism region through two sequential phases. At the first phase, a unique set of 19 sustainable tourism indicators resulted from a triplex model was used to examine the sustainability effects on the main factors of residents’ well-being including equity and living condition, life satisfaction, health condition, and education quality. The triplex model including i) systematic literature search, ii) convergent interviewing, and iii) DEMATEL aimed to develop sustainability indicators, specify them for a particular destination, and identify the dominant sustainability issues acting as key predictors in sustainable development. At the second phase, a hierarchical multiple regression was used to examine the relationship between sustainable development and local residents’ well-being. A number of 167 participants from five different groups of stakeholders perceived the importance level of each sustainability indicators regarding well-being factors on 5-point Likert scale. Results from the first phase indicated that sustainability training, government support, tourism sociocultural effects, tourism revenue, and climate change are the top dominant sustainability issues in the regional sustainable development. Results from the second phase showed that sustainable development considerably improves the overall residents’ well-being and has positive relationships with all well-being factors except life satisfaction. It explains that it was difficult for stakeholders to recognize a link between sustainable development and their overall life satisfaction and happiness. Among well-being’s factors, health condition was influenced the most by sustainability indicators that indicate stakeholders believed sustainability development can promote public health, health sector performance, quality of drinking water, and sanitation. For the future research, it is highly recommended to analysis the effects of sustainable tourism development on the other features of a tourism destination’s well-being including residents sociocultural empowerment, local economic growth, and attractiveness of the destination.

Keywords: residents' well-being, stakeholder perception, sustainability indicators, sustainable tourism

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Authors: Allyson Dale, Max Hlywa

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The Canadian public expects the highest moral standards from Canadian Armed Forces (CAF) members and Department of National Defence (DND) employees. The Chief, Professional Conduct and Culture (CPCC) stood up in April 2021 with the mission of ensuring that the defence culture and members’ conduct are aligned with the ethical principles and values that the organization aspires towards. The Defence Ethics Program (DEP), which stood up in 1997, is a values-based ethics program for individuals and organizations within the DND/CAF and now falls under CPCC. The DEP is divided into five key functional areas, including policy, communications, collaboration, training and education, and advice and guidance. The main focus of the DEP is to foster an ethical culture within defence so that members and organizations perform to the highest ethical standards. The measurement of organizational ethics is often complex and challenging. In order to monitor whether the DEP is achieving its intended outcomes, a performance measurement framework (PMF) was developed using the Director General Military Personnel Research and Analysis (DGMPRA) PMF development process. This evidence-based process is based on subject-matter expertise from the defence team. The goal of this presentation is to describe each stage of the DGMPRA PMF development process and to present and discuss the products of the DEP PMF (e.g., logic model). Specifically, first, a strategic framework was developed to provide a high-level overview of the strategic objectives, mission, and vision of the DEP. Next, Key Performance Questions were created based on the objectives in the strategic framework. A logic model detailing the activities, outputs (what is produced by the program activities), and intended outcomes of the program were developed to demonstrate how the program works. Finally, Key Performance Indicators were developed based on both the intended outcomes in the logic model and the Key Performance Questions in order to monitor program effectiveness. The Key Performance Indicators measure aspects of organizational ethics such as ethical conduct and decision-making, DEP collaborations, and knowledge and awareness of the Defence Ethics Code while leveraging ethics-related items from multiple DGMPRA surveys where appropriate.

Keywords: defence ethics, ethical culture, organizational performance, performance measurement framework

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