Search results for: professional ethics

Authors: Jing Niu, Jun X. Wang

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Arterial stiffness predicts mortality and morbidity, independently of other cardiovascular risk factors. And it is a major risk factor for age-related morbidity and mortality. The non-invasive industry gold standard measurement system of arterial stiffness utilizes pulse wave velocity method. However, the desktop device is expensive and requires trained professional to operate. The main objective of this research is the proof of concept of the proposed non-invasive method which uses measurement of magnetic flux disturbance and electrocardiogram (ECG) signal for measuring arterial stiffness. The method could enable accurate and easy self-assessment of arterial stiffness at home, and to help doctors in research, diagnostic and prescription in hospitals and clinics. A platform for assessing arterial stiffness through acquisition and analysis of radial artery pulse waveform and ECG signal has been developed based on the proposed method. Radial artery pulse waveform is acquired using the magnetic based sensing technology, while ECG signal is acquired using two dry contact single arm ECG electrodes. The measurement only requires the participant to wear a wrist strap and an arm band. Participants were recruited for data collection using both the developed platform and the industry gold standard system. The results from both systems underwent correlation assessment analysis. A strong positive correlation between the results of the two systems is observed. This study presents the possibility of developing an accurate, easy to use and affordable measurement device for arterial stiffness assessment.

Keywords: arterial stiffness, electrocardiogram, pulse wave velocity, Magnetic Flux Disturbance

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a clinical state associated with low-grade inflammation. It is also a major risk factor for insulin resistance (IR). In its advanced stages, metabolic syndrome (MetS), a much more complicated disease which may lead to life-threatening problems, may develop. Obesity-mediated IR seems to correlate with the inflammation. Human studies performed particularly on pediatric population are scarce. The aim of this study is to detect possible associations between inflammation and IR in terms of some related ratios. 549 children were grouped according to their age- and sex-based body mass index (BMI) percentile tables of WHO. MetS components were determined. Informed consent and approval from the Ethics Committee for Clinical Investigations were obtained. The principles of the Declaration of Helsinki were followed. The exclusion criteria were infection, inflammation, chronic diseases and those under drug treatment. Anthropometric measurements were obtained. Complete blood cell, fasting blood glucose, insulin, and C-reactive protein (CRP) analyses were performed. Homeostasis model assessment of insulin resistance (HOMA-IR), systemic immune inflammation (SII) index, tense index, alanine aminotransferase to aspartate aminotransferase ratio (ALT/AST), neutrophils to lymphocyte (NLR), platelet to lymphocyte, and lymphocyte to monocyte ratios were calculated. Data were evaluated by statistical analyses. The degree for statistical significance was 0.05. Statistically significant differences were found among the BMI values of the groups (p < 0.001). Strong correlations were detected between the BMI and waist circumference (WC) values in all groups. Tense index values were also correlated with both BMI and WC values in all groups except overweight (OW) children. SII index values of children with normal BMI were significantly different from the values obtained in OW, obese, morbid obese and MetS groups. Among all the other lymphocyte ratios, NLR exhibited a similar profile. Both HOMA-IR and ALT/AST values displayed an increasing profile from N towards MetS3 group. BMI and WC values were correlated with HOMA-IR and ALT/AST. Both in morbid obese and MetS groups, significant correlations between CRP versus SII index as well as HOMA-IR versus ALT/AST were found. ALT/AST and HOMA-IR values were correlated with NLR in morbid obese group and with SII index in MetS group, (p < 0.05), respectively. In conclusion, these findings showed that some parameters may exhibit informative differences between the early and late stages of obesity. Important associations among HOMA-IR, ALT/AST, NLR and SII index have come to light in the morbid obese and MetS groups. This study introduced the SII index and NLR as important inflammatory markers for the discrimination of normal and obese children. Interesting links were observed between inflammation and IR in morbid obese children and those with MetS, both being late stages of obesity.

Keywords: children, inflammation, insulin resistance, metabolic syndrome, obesity

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Authors: Avinash Kharel

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Background: - Linear sprint training is one possible approach to developing sprint performance, a crucial skill to focus on in soccer. Numerous methods, including various on-field training options, can be employed to attain this goal. However, the effect of In-season linear sprint training on sprint performance and related kinetics changes are unknown in a professional setting. The study aimed to investigate the effect of in-season linear sprint training on the sprint kinematics of amateur soccer players. Methods: - After familiarization, a 4-week training protocol was completed with sprint performance and Force Velocity (FV) profiles was compared before and after the training. Eighteen amateur soccer male players (Age 22 ± 2 years: Height: 178 ± 7cm; body-mass: 74 ± 8 Kg, 30-m split-time: 4.398 ± s) participated in the study. Sprint kinematics variables, including maximum Sprint Velocity (V0), Theoretical Maximum Force (F0), Maximum Force Output per kilogram of body weight (N/KG), Maximum Velocity (V(0)), Maximum Power Output (P MAX (W)), Ratio of Force to Velocity (FV), and Ratio of Force to Velocity at Peak power were measured. Results: - Results showed significant improvements in Maximum Sprint Velocity (p<0.01, ES=0.89), Theoretical Maximum Force (p<0.05, ES=0.50), Maximum Force Output per kilogram of body weight (p<0.05, ES=0.42), Maximum Power Output (p<0.05, ES=0.52), and Ratio of Force to Velocity at Peak Power (RF PEAK) (p<0.05, ES=0.44) post-training. There were no significant changes in the ratio of Force to Velocity (FV) and Maximum Velocity V (0) post-training (p>0.05). Conclusion: - These findings suggest that In-season linear sprint training can effectively improve certain sprint kinematics variables in amateur soccer players. Coaches and players should consider incorporating linear sprint training into their in-season training programs to improve sprint performance.

Keywords: sprint performance, training intervention, soccer, kinematics

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Authors: Leonard Tiong, Sonit Singh, Kevin Ho Shon, Sarah Lewis

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Investigation into the use of artificial intelligence in radiology continues to develop at a rapid rate. During the coronavirus pandemic, the combination of an exponential increase in chest x-rays and unpredictable staff shortages resulted in a huge strain on the department's workload. There is a World Health Organisation estimate that two-thirds of the global population does not have access to diagnostic radiology. Therefore, there could be demand for a program that could detect acute changes in imaging compatible with infection to assist with screening. We generated a conventional neural network and tested its efficacy in recognizing changes compatible with coronavirus infection. Following ethics approval, a deidentified set of 77 normal and 77 abnormal chest x-rays in patients with confirmed coronavirus infection were used to generate an algorithm that could train, validate and then test itself. DICOM and PNG image formats were selected due to their lossless file format. The model was trained with 100 images (50 positive, 50 negative), validated against 28 samples (14 positive, 14 negative), and tested against 26 samples (13 positive, 13 negative). The initial training of the model involved training a conventional neural network in what constituted a normal study and changes on the x-rays compatible with coronavirus infection. The weightings were then modified, and the model was executed again. The training samples were in batch sizes of 8 and underwent 25 epochs of training. The results trended towards an 85.71% true positive/true negative detection rate and an area under the curve trending towards 0.95, indicating approximately 95% accuracy in detecting changes on chest X-rays compatible with coronavirus infection. Study limitations include access to only a small dataset and no specificity in the diagnosis. Following a discussion with our programmer, there are areas where modifications in the weighting of the algorithm can be made in order to improve the detection rates. Given the high detection rate of the program, and the potential ease of implementation, this would be effective in assisting staff that is not trained in radiology in detecting otherwise subtle changes that might not be appreciated on imaging. Limitations include the lack of a differential diagnosis and application of the appropriate clinical history, although this may be less of a problem in day-to-day clinical practice. It is nonetheless our belief that implementing this program and widening its scope to detecting multiple pathologies such as lung masses will greatly assist both the radiology department and our colleagues in increasing workflow and detection rate.

Keywords: artificial intelligence, COVID, neural network, machine learning

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Authors: V. De Sandi

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In this paper, we characterize a class of rank-weighted social welfare orderings that we call ”Excessivist.” The Excessivist Social Welfare Ordering (eSWO) judges incomes above a fixed threshold θ as detrimental to society. To accomplish this, the identification of a richness or affluence line is necessary. We employ a fixed, exogenous line of excess. We define an eSWF in the form of a weighted sum of individual’s income. This requires introducing n+1 vectors of weights, one for all possible numbers of individuals below the threshold. To do this, the paper introduces a slight modification of the class of rank weighted class of social welfare function. Indeed, in our excessivist social welfare ordering, we allow the weights to be both positive (for individuals below the line) and negative (for individuals above). Then, we introduce ethical concerns through an axiomatic approach. The following axioms are required: continuity above and below the threshold (Ca, Cb), anonymity (A), absolute aversion to excessive richness (AER), pigou dalton positive weights preserving transfer (PDwpT), sign rank preserving full comparability (SwpFC) and strong pareto below the threshold (SPb). Ca, Cb requires that small changes in two income distributions above and below θ do not lead to changes in their ordering. AER suggests that if two distributions are identical in any respect but for one individual above the threshold, who is richer in the first, then the second should be preferred by society. This means that we do not care about the waste of resources above the threshold; the priority is the reduction of excessive income. According to PDwpT, a transfer from a better-off individual to a worse-off individual despite their relative position to the threshold, without reversing their ranks, leads to an improved distribution if the number of individuals below the threshold is the same after the transfer or the number of individuals below the threshold has increased. SPb holds only for individuals below the threshold. The weakening of strong pareto and our ethics need to be justified; we support them through the notion of comparative egalitarianism and income as a source of power. SwpFC is necessary to ensure that, following a positive affine transformation, an individual does not become excessively rich in only one distribution, thereby reversing the ordering of the distributions. Given the axioms above, we can characterize the class of the eSWO, getting the following result through a proof by contradiction and exhaustion: Theorem 1. A social welfare ordering satisfies the axioms of continuity above and below the threshold, anonymity, sign rank preserving full comparability, aversion to excessive richness, Pigou Dalton positive weight preserving transfer, and strong pareto below the threshold, if and only if it is an Excessivist-social welfare ordering. A discussion about the implementation of different threshold lines reviewing the primary contributions in this field follows. What the commonly implemented social welfare functions have been overlooking is the concern for extreme richness at the top. The characterization of Excessivist Social Welfare Ordering, given the axioms above, aims to fill this gap.

Keywords: comparative egalitarianism, excess income, inequality aversion, social welfare ordering

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: Elena G. Diryugina, Maria A. Dovger, Maria V. Lunkina, Alexandra A. Ianchenko

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The personality development and well-being of children have become important focuses of school education and indicators of its quality. The studies show that academic success depends more on personality and motivation than on intelligence and giftedness. Those personality resources that help a person to maintain well-being both here and now and in the future constitute their personality potential. The development of schoolchildrens' personality potential can help them meet the challenges of the modern world and achieve new educational goals. At the same time, it is noted that the pedagogical factor is one of the most significant in relation to schoolchildrens' success and well-being. What is important for teachers to develop in order to make their students feel more competent and maintain well-being? As part of the Developmental Environment Programme of the Charitable Foundation ‘Investment in the Future’, a longitudinal study of the personality potential and well-being of educators and schoolchildren was conducted from 2018 to 2023. More than 2,500 teachers and over 4,000 students from Russia took part. It was found that behind a teacher's communication style, an important construct that influences the motivation of schoolchildren and the satisfaction of their basic psychological needs, is the personal potential of that teacher. Their personality potential correlates with the social-emotional development of schoolchildren in junior grades. A teacher's communication style with adolescents contributes to their academic motivation, self-esteem and satisfaction with life and learning. In addition, child well-being cannot be promoted in isolation from attention to the psychological well-being of teachers. Their social well-being and engagement are higher when they are included in professional learning communities. The results will be helpful for both positive education researchers and practitioners to identify an approach to child personality development and well-being that is achieved primarily through the personality development and well-being of school staff members and mostly teachers.

Keywords: Personality development, personality potential, schoolchildren, teaching style, well-being

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Authors: Karla Hrbackova, Anna Petr Safrankova, Jakub Hladik

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Machiavellianism as social phenomenon reveals certain methods of communication that man puts in contact with other people in both personal and working life (and work with clients). Especially at the helping-profession students is honesty, openness or low motivation for personal benefit important part of the profession. The aim of a study is to expose intercultural differences influence of Machiavellianism between Czech and Slovak university students and to determine whether these differences manifest themselves differently among students focusing on management and social profession (by helping degrees). The research involved 1120 university students from the Czech Republic and the Slovak Republic. The measurement of Machiavellianism used a test Mach IV. The test contained 20 statements divided into four central dimensions of Machiavellianism: flattery, deception and falsehood, immorality and cynicism. We found out, that Czech and Slovak's student expressed a similar attitude toward Machiavellianism as a means of manipulation in the interpersonal relationship, but this is not true in all dimensions. Czech and Slovak's students perceive differently flattery, deception and falsehood and cynicism too. In addition to specific features of cultural conditionality, we found out differences depending on the helping profession. Students focusing on managerial occupation (lower level of helping) tend towards greater acceptance of the use flattery as a means of communication than students specializing in the social profession (high-grade assisting). If they are an intercultural and interdisciplinary influences combined and effect on the perception of Machiavellianism together, then their significant importance for the perception of flattery and cynicism. The result will help us to reveal certain specific traits that students apply communication and with whom we can continue to work during their training.

Keywords: use of manipulative strategies, Machiavellianism, helping-profession students, professional training of students

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

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Authors: Sevdenur Onger, Ali Asram Sagiroglu

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Hyperpigmentation is a cosmetically unappealing skin problem caused by an overabundance of melanin in the skin. Its pathophysiology is caused by melanocytes being exposed to paracrine melanogenic stimuli, which can upregulate melanogenesis-related enzymes (such as tyrosinase) and cause melanosome formation. Tyrosinase is linked to the development of melanosomes biochemically, and it is the main target of hyperpigmentation treatment. therefore, decreasing tyrosinase activity to reduce melanosomes has become the main target of hyperpigmentation treatment. Niacinamide (NA) is a natural chemical found in a variety of plants that is used as a skin-whitening ingredient in cosmetic formulations. NA decreases melanogenesis in the skin by inhibiting melanosome transfer from melanocytes to covering keratinocytes. Furthermore, NA protects the skin from reactive oxygen species and acts as a main barrier with the skin, reducing moisture loss by increasing ceramide and fatty acid synthesis. However, it is very difficult for hydrophilic compounds such as NA to penetrate deep into the skin. Furthermore, because of the nicotinic acid in NA, it is an irritant. As a result, we've concentrated on strategies to increase NA skin permeability while avoiding its irritating impacts. Since nanotechnology can affect drug penetration behavior by controlling the release and increasing the period of permanence on the skin, it can be a useful technique in the development of whitening formulations. Liposomes have become increasingly popular in the cosmetics industry in recent years due to benefits such as their lack of toxicity, high penetration ability in living skin layers, ability to increase skin moisture by forming a thin layer on the skin surface, and suitability for large-scale production. Therefore, liposomes containing NA were developed for this study. Different formulations were prepared by varying the amount of phospholipid and cholesterol and examined in terms of particle sizes, polydispersity index (PDI) and pH values. The pH values of the produced formulations were determined to be suitable with the pH value of the skin. Particle sizes were determined to be smaller than 250 nm and the particles were found to be of homogeneous size in the formulation (pdi<0.30). Despite the important advantages of liposomal systems, they have low viscosity and stability for topical use. For these reasons, in this study, liposomal cream formulations have been prepared for easy topical application of liposomal systems. As a result, liposomal cream formulations containing NA have been successfully prepared and characterized. Following the in-vitro release and ex-vivo diffusion studies to be conducted in the continuation of the study, it is planned to test the formulation that gives the most appropriate result on the volunteers after obtaining the approval of the ethics committee.

Keywords: delivery systems, hyperpigmentation, liposome, niacinamide

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Authors: Joel S. Akintayo, Ramat T. Salman

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The stakeholders’ pressure on corporate managers to maintain firm’s profitability has created economic incentives for management to engage in earnings management practices. Therefore, this study examines the effects of audit quality and corporate governance on earnings management of quoted deposit money banks (DMBs) in Nigeria. This study specifically investigates the influence of audit tenure, audit fee, board independence, and board size on earnings management of DMBs. Explanatory research design was employed in carrying out the study while secondary data were sourced from the annual reports and accounts of all the 15 quoted DMBs in Nigerian Stock Exchange as at December 31, 2015 for a period of 10 years covering from 2006 to 2015. The data obtained for the study were analyzed using panel regression analysis approach. The findings reveal that board independence has a negative significant effect on earnings management at a 5% level of significance (p=0.002), while audit fee has a positive significant effect on earnings management at a 5% level of significance (p=0.013) and audit tenure has a negative significant effect on earnings management of DMBs at a 5% level of significance (p=0.003). Surprisingly, board size was statistically not significant at a 5% level of significance (p=0.086). The study concludes that high audit quality and sound corporate governance could improve the earnings quality of DMBs. Hence, the study recommends that the authorities saddled with the responsibility of banking supervision in Nigeria such the Securities and Exchange Commission (SEC) and CBN to advise the National Assembly in Nigeria to pass into law the three years professional requirement for audit tenure.

Keywords: audit quality, audit tenure, audit fee, board independence, corporate governance, earnings management

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

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Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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Authors: Sharon Sibanda, Benny Motileng

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The World Health Organisation (WHO) identified the Sars-Cov-2 (COVID-19) as a pandemic on the 12ᵗʰ of March 2020, with South Africa recording its first case on the 5ᵗʰ of March 2020. The rapidly spreading virus led the South African government to implement one of the strictest nationwide lockdowns globally, resulting in the closing down of all institutions of higher learning effective March 18ᵗʰ 2020. Thus, this qualitative study primarily aimed to explore whether post-graduate psychology students were in a state of a depleted or cohesive self, post the psychological isolation of COVID-19 risk-adjusted level 5 lockdown. Semi-structured interviews from a qualitative interpretive approach comprising N=6 psychology post-graduate students facilitated a rich understanding of their intra-psychic experiences of the self. Thematic analysis of data gathered from the interviews illuminated how students were forced into the self by the emotional isolation of hard lockdown, with the emergence of core psychic conflict often defended against through external self-object experiences. The findings also suggest that lockdown stripped off this sample of psychology post-graduate students’ defensive escape from the inner self through external self-object distractions. The external self was stripped to the core of the internal self by the isolation of hard lockdown, thereby uncovering the psychic function of roles and defenses amalgamated throughout modern cultural consciousness that dictates self-functioning. The study suggests modelling reflexivity skills in the integration of internal and external self-experience dynamics as part of a training model for continued personal and professional development for psychology students.

Keywords: COVID-19, fragmentation, self-object experience, true/false self

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Authors: Mei-Chun. Chang

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STEAM (Science, Technology, Engineering, Art, and Mathematics) represents a cross-disciplinary and learner-centered teaching model that cultivates students to link theory with the presentation of real situations, thereby improving their various abilities. This study explores students' learning performance after using the 6E model in STEAM teaching for a professional course in the digital media design department of technical colleges, as well as the difficulties and countermeasures faced by STEAM curriculum design and its implementation. In this study, through industry experts’ work experience, activity exchanges, course teaching, and experience, learners can think about the design and development value of virtual idol products that meet the needs of users and to employ AR/VR technology to innovate their product applications. Applying action research, the investigation has 35 junior students from the department of digital media design of the school where the researcher teaches as the research subjects. The teaching research was conducted over two stages spanning ten weeks and 30 sessions. This research collected the data and conducted quantitative and qualitative data sorting analyses through ‘design draft sheet’, ‘student interview record’, ‘STEAM Product Semantic Scale’, and ‘Creative Product Semantic Scale (CPSS)’. Research conclusions are presented, and relevant suggestions are proposed as a reference for teachers or follow-up researchers. The contribution of this study is to teach college students to develop original virtual idols and product designs, improve learning effectiveness through STEAM teaching activities, and effectively cultivate innovative and practical cross-disciplinary design talents.

Keywords: STEAM, 6E model, virtual idol, learning effectiveness, practical courses

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Authors: Ali A. Karakhan

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Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.

Keywords: healthy buildings, smart construction, innovative designs, sustainable projects

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Authors: Lelika Lazarus, Reshma Sookrajh, Kapil S. Satyapal

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Reflecting on teaching is commonly cited as a fundamental practice for personal and professional development. Educational research into the scholarship of teaching and learning anatomy includes engaging in discipline specific literature on teaching, reflecting on individual teaching methods and communicating these findings to peers. The aim of this paper is to formally assess the opinions of senior anatomy instructors regarding the state of anatomical knowledge at their respective institutions. The context of the paper derives from ongoing debates about the perceived decline in standards of anatomical knowledge of medical students and postgraduate learners. An open ended questionnaire was devised consisting of eight direct questions seeking opinions on anatomy teaching, knowledge, and potential educational developments and general thoughts on the teaching of anatomy to medical students. These were distributed to senior anatomy Faculty (identified by the author by their affiliation with the Anatomical Society of Southern Africa) based at the eight national medical schools within the country. A number of key themes emerged. Most senior faculty felt that the standard of medical education at their respective institutions was ‘good.’. However, emphasis was also placed on the ‘quality of teaching’ incorporating clinical scenarios. There were also indications that staff are split into those that are keen to do research and those that are happy to provide teaching to medical students as their primary function. Several challenges were also highlighted such as time constraints within the medical curriculum, the lack of cadavers to reinforce knowledge and gain depth perception and lack of appropriately qualified staff. Recommendations included fostering partnerships with both clinicians and medical scientists into the anatomy curriculum thus improving teaching and research.

Keywords: anatomy, education, reflection, teaching

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Authors: Nilüfer Kuru, Berrin Akman

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In this study, science process skills of children with ages varying between 48-months and 66-months are analyzed. Science process skills of children are investigated in terms of factors including gender of children, attendance of children to the previous educational institution and duration of their attendance, educational background of their parents, ages of children and teachers, professional experience of teachers, educational background, and department of graduation of teachers, type of pre-school education institution of teachers and children. Sample of research consists of 250 children aged between 48-months and 66-months who attend state and private kindergartens under the Ministry of National Education, nursery classes of elementary schools and kindergartens of establishments in central districts of Ankara and 50 teachers who serve in these children’s classes. Science Observation Form, reached from the website of Alaska Department of Education & Early, are analyzed in terms of language, content, construct validity, and reliability by the researchers. Additionally, Personal Information Form is also developed by the researchers. Data obtained in the study are analyzed with SPSS 16.0 package program to obtain percentage and frequency, Kruskal Wallis H-test, and Mann- Whitney U test, which are one of the non-parametric tests, are used. Within the context of this study it has been seen that independent variables of age, type of school attending and status of attendance to pre-school education, educational background of children’s father are meaningful expositive in gaining science process skills for children. It has been seen that period of service of teachers, duration of attendance to pre-school education for children, gender of children and educational background of children’s mother are not meaningful expositive in gaining science process skills for children.

Keywords: preschool, science process skills, early childhood education, science

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Authors: Jenney Perez Bacalla

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The study was conducted to assess the five (5) identified school administrators of the identified secondary schools in terms of professional characteristics, management skills and values patterns in the Division of Leyte Area IV for a proposed enhancement model for school administrators. The study utilized the qualitative method. There were two (2) groups of respondents: the teachers and the school administrators. The teachers perceived the management skills of the school administrators in their technical and conceptual skills and values in planning and organizing work, allocating and using of funds, submitting reports, decision-making, leading people, public relations and community involvement and other value development. It was found out in the study that most of the school administrators’ management skills were very well manifested. Their value patterns were also very well manifested. Most of them had earned master’s degree and with a unit in doctoral and five (5) years and above in service as a school administrator. Most administrators were performing and successfully execute the planning, organizing and utilizing funds and they were able to lead their subordinates. In planning, it shows that administrators studied the future and arrange the plan. Administrators also were able to manage, maintained the good environment wherein individual work together. School administrators were creating an environment conducive to learning. The school administrator is manifesting the desirable practices in school management. In terms of their educational qualifications, they were all qualified. Academic preparation, trainings and maturation were their attributes to the development of managerial skills of the school administrators. They showed competence in the areas of management skills that they were able to carry their functions with utmost responsibility and capability. School administrators in terms of seminars and trainings on administration and supervision were already equipped. It is concluded that the school administrators possessed the necessary skills and work values in administering the school.

Keywords: management skills and values, public secondary schools, qualitative, school administrators

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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Authors: Kanu Priya Mohan

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Innovation in education is one of the essential pathways to achieve both educational, and development goals in today’s dynamically changing world. Over the last decade, coaching and mentoring have been applied in the field of education as positive intervention techniques for fostering teaching and learning reforms in the developed countries. The context of this research was Thailand’s educational reform process, wherein a project on coaching and mentoring (C&M) was launched in 2014. The C&M project endeavored to support the professional development of the school teachers in the various provinces of Thailand, and to also enable them to apply C&M for teaching innovative instructional techniques. This research aimed to empirically investigate the learning outcomes for the master trainers, who trained for coaching and mentoring as the first step in the process to train the school teachers. A mixed method study was used for evaluating the learning outcomes of training in terms of cognitive- behavioral-affective dimensions. In the first part of the research a quantitative research design was incorporated to evaluate the effects of learner characteristics and instructional techniques, on the learning outcomes. In the second phase, a qualitative method of in-depth interviews was used to find details about the training outcomes, as well as the perceived barriers and enablers of the training process. Sample size constraints were there, yet these exploratory results, integrated from both methods indicated the significance of evaluating training outcomes from the three dimensions, and the perceived role of other factors in the training. Findings are discussed in terms of their implications for the training of C&M, and also their impact in fostering positive education through innovative educational techniques in the developing countries.

Keywords: cognitive-behavioral-affective learning outcomes, mixed method research, teachers in Thailand, training evaluation

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Authors: Fitim Sadiku, Mjellma Rexhepi, Kreshnik Grezda, Jonijana Sadiku Tigani, Merita Qorolli, Blerta Rexhepi-Kelmendi, Zelie Sadiku, Laura Cakolli

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Background: According to the European Alliance of Associations for Rheumatology (EULAR), biologics should be considered alongside traditional treatments in Ankylosing Spondylitis (AS) patients with persistently high disease activity that directly affects functional capacity. Unfortunately, Kosovo’s health system only offers continuous treatment with etanercept (ETN), and most of the patients with AS are referred to be treated with this biological substance. Objectives: This study aims to explore the relationship between comorbidity, disease activity, and functional capacity in AS patients undergoing ETN treatment in Kosovo. Methods: In this cross-sectional study, we included patients diagnosed with AS who were being treated with ETN 50mg per week for at least 6 months at the Rheumatology Clinic of the University Clinical Center of Kosovo. Patients under 18, pregnant women, and patients with spinal fractures were excluded. This study was approved by the Ethics Committee of the Faculty of Medicine, University of Prishtina and a consent form was signed by patients for participating in the study. We collected data (September-December 2023) about socio-demographics and disease history. Moreover, the presence of comorbidities was measured by the Comorbidity Charlson Index; the disease activity was measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS), and the functional capacity was measured by the Bath Ankylosing Spondylitis Functional Index (BASFI). Results: A total of 31 out of the 39 patients with AS receiving etanercept were included aged 18 to above 65 years (M= 40 years, SD= 14.39), and 87% were male. Diagnose delay was, on average, 7 years from the first symptoms (min-max= 0-24), while the disease duration on average was 7.5 years (min-max= 1- 50). Treatment duration with etanercept was from 0.5 to 6 years. The results indicate a significant positive correlation between comorbidity and BASFI (r= .615, p= .01) and disease activity. Additionally, a significant positive correlation exists between disease activity and BASFI (r= .507, p= .004). Regression analysis highlights the significance of both comorbidity and disease activity as predictors of patients’ functional capacity F (1, 29) = 10.047, p= .05 and F(1, 29) = 17.678, p= .01. No notable gender differences were observed. The study found no significant variations in comorbidity, disease activity, and functional capacity concerning the duration of ETN treatment. Conclusion: We found that in Kosovo, it takes at least 7 years for individuals to be diagnosed with AS from the first-time symptoms are experienced. This study showed that there is a positive correlation between comorbidity and functional capacity, disease activity and functional capacity in patients with AS undergoing etanercept treatment. Furthermore, results showed that comorbidity and disease activity are predictors of the functional status of the patients with AS receiving ETN. Gender and treatment duration with etanercept did not show any significant variations in these patients.

Keywords: ankylosing spondilitis, etanercept, physical wellbeing, comorbidities

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Remi Szauer

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Introductory, Background, and Importance of the Study: For many years, religiosity in Poland remained at a stable level of religious practice. When the symptoms of secularization and privatization processes appeared in Poland, it was not clearly felt but rather related to the decline in compulsory practices carried out in public, the growing distance of respondents to catholic ethic, and the lack of acceptance regarding the intervention of the Church in legislation and policy. The basic indicators observed over the years kept the picture: more religious women - less religious men. By carrying out own research in the field of religious and moral attitudes in 2019-2021, it was noticed that a reversal of the trend preserved over the years could be observed. The data showed that women under 40 are radically different in their responses than women older than them - especially those over 50: in terms of practices or ties with the Church and many more specific aspects. This became the basis for a careful examination of the responses in the under 40 age cohorts among women. This study is significant because it shows completely new perspectives of women's perception of religiosity and allows us to notice clearly the aspects of social changes mapped in the minds of the surveyed women. Research Methodology: The original survey was carried out using the quantitative method among 2,346 respondents in northern Poland, 1,349 of whom were women. The findings from these observations led to deepening the topic of beliefs of women under 40 compared to other age cohorts of women. Hence, studies were carried out on the general population of women in Poland, which constituted a comparative sample. These were panel studies. The selection of the sample among women was random, respecting the age amounts so that the two statistical groups could be compared. The designated research parameters included: declarations of religious faith, declarations of religious practice, bond with the Church, acceptance of Mariological dogmas, attitude towards the image of women in the Church, and acceptance of selected issues in Catholic ethics. Main Research Findings: Among women under 40, the decline in declarations not only concerning compulsory public practices but also private practices and declarations of religious faith is more pronounced. Not only is the range of indifferent religious attitudes increasing, but also attitudes directly declaring religious disbelief, for which there are important justifications. Women under 40 years of age strongly distance themselves from the institutions of the Church and from accepting Mariological dogmas. Moreover, they note that the image of a woman is marked by stereotyping, favoring the intensification of violence against women, as well as disregarding her potential and agency. Concluding Statement: By analyzing the answers of the female respondents and the data obtained in the research, it can be observed a reevaluation of women's beliefs, which opens the perspective of analyzing the role of religion and the Church in Poland as well as religious socialization.

Keywords: religiosity, morality, gender, feminism, social change

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Authors: Gunay Imanguliyeva

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Burnout is one of the concerning issues in education. The present paper aimed to explore the concept of burnout among program directors and faculty working in three higher education institutions (HEIs) in Azerbaijan and identify the factors contributing to burnout and the possible consequences of this syndrome on research participants’ professional and personal life. The researcher believed that if the concept of burnout was defined precisely and explored among more faculty, administration, and educational institutions, university leadership may have looked for the ways to support program directors and faculty, which would increase job satisfaction and decrease turnover. An exploratory qualitative research design was chosen for this study. The conceptual framework of this study was based on the Maslach Burnout Inventory. The instruments of the research were semi-structured interviews, observation, and document review. Three EFL (Teaching English as a Foreign Language) instructors and three program directors of the English Language Department working in three higher educational institutions in Azerbaijan participated in this study. The major findings of this study showed that both program directors and faculty suffered from burnout. Though they were aware of the factors that caused burnout, they did not know how to deal with this feeling. While research participants had high feeling of Emotional Exhaustion and Depersonalization, they had a low feeling of Personal Accomplishment. The researcher suggests that further research is important to measure the level of burnout and to enable HEIs to increase the productivity of program directors’ and faculty’s work as well as decrease the rate of retention in future. Also, in order to help program directors and faculty to cope with burnout, the research recommends the university leadership to meet their psycho-social needs, emotional-physical needs, and personal-intellectual needs. Keywords: burnout, emotional exhaustion, factors, well-being, higher education

Keywords: burnout, well-being, higher education, factors

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Authors: Thi Phuong Lan Nguyen

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The English Language Teacher Education (ELTE) in Vietnam is rapidly changing to address the new requirements of the globalization and socialization era. Although there has been a range of investments and innovation in policy and curriculum, tertiary educators and learners do not engage in the enactment. It is vital to understand the practices at the tertiary education level. The study is to understand the higher education curriculum development policy, both in theory and in practice across four representatives of ELTE institutions in the North of Vietnam. The lecturers’ perceptions about the extent to which the enacted curriculum is aligned with national standards will be explored. Nineteen policy documents, seventy surveys, and twelve interviews with lecturers and instructional leaders across these four Vietnamese Northern ELTE institutions have been analyzed to investigate how the policy shape the practice. The two most significant findings are (i) a low level of alignment between curriculum and soft-skills standards of the graduates required by the Vietnamese Ministry of Education and Training (MOET) and (ii) incoherence between current national policy and these institutions’ implementation. In order to address these gaps, it is strongly recommended that curriculum needs to be further developed, focusing more on the institutional outcomes, MOET’s standards, and the social demands in times of globalization. More importantly, professional development in ELTE is vital for a range of curriculum and educational policy stakeholders. The study helps to develop the English teaching profession in Vietnam in a systematic way, from policymakers to implementers, and from instructors to learners. Its significance lies in its relevance to English teaching careers, particularly within the researcher’s specific context, yet also remains relevant to ELTE in other parts of Vietnam and in other EFL (English as a Foreign Language) countries.

Keywords: curriculum, English language teaching education, policy implementation, standard, teaching practice

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Authors: Carmela Perta

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Among the studies flourished in the field of historical sociolinguistics, mainly in the strand devoted to English history, during its Medieval and early modern phases, multilingual texts had been analysed using theories and models coming from contact linguistics, thus applying synchronic models and approaches to the past. This is true also in the case of contact phenomena which would transcend the writing level involving the language systems implicated in contact processes to the point of perceiving a new variety. This is the case for medieval administrative-commercial texts in which, according to some Scholars, the degree of fusion of Anglo-Norman, Latin and middle English is so high a mixed code emerges, and there are recurrent patterns of mixed forms. Interesting is a collection of multilingual business writings by John Balmayn, an Englishman overseeing a large shipment in Tuscany, namely the Cantelowe accounts. These documents display various analogies with multilingual texts written in England in the same period; in fact, the writer seems to make use of the above-mentioned patterns, with Middle English, Latin, Anglo-Norman, and the newly added Italian. Applying an atomistic yet dynamic approach to the study of contact phenomena, we will investigate these documents, trying to explore the nature of the switching forms they contain from an intra-writer variation perspective. After analysing the accounts and the type of multilingualism in them, we will take stock of the assumed mixed code nature, comparing the characteristics found in this genre with modern assumptions. The aim is to evaluate the possibility to consider the switching forms as core elements of a mixed code, used as professional variety among merchant communities, or whether such texts should be analysed from a switching perspective.

Keywords: historical sociolinguistics, historical code switching, letters, medieval england

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Authors: Myoungsoon You, Heejung Son

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Background: In the current study, we investigated the effects of emotions induced by an infectious disease outbreak on the various protective behaviors taken during the crisis and on the perception after the crisis. The investigation was based on two psychological theories of appraisal tendency and action tendency. Methods: A total of 900 participants in South Korea who experienced the 2015 Middle East Respiratory Syndrome outbreak were sampled by a professional survey agency. To assess the influence of the emotions fear and anger, a regression approach was used. The effect of emotions on various protective behaviors and perceptions was observed using a hierarchical regression method. Results: Fear and anger induced by the infectious disease outbreak were both associated with increased protective behaviors during the crisis. However, the differences between the emotions were observed. While protective behaviors with avoidance tendency (adherence to recommendations, self-mitigation), were raised by both fear and anger, protective behaviors with approach tendency (information-seeking) were increased by anger, but not fear. Regarding the effect of emotion on the risk perception after the crisis, only fear was associated with a higher level of risk perception. Conclusions: This study confirmed the role of emotions in crisis protective behaviors and post-crisis perceptions regarding an infectious disease outbreak. These findings could enhance understanding of the public’s protective behaviors during infectious disease outbreaks and afterward risk perception corresponding to emotions. The results also suggested strategies for communicating with the public that takes into account emotions that are prominently induced by crises associated with disease outbreaks.

Keywords: crisis communication, emotion, infectious disease outbreak, protective behavior, risk perception

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