Search results for: teacher job satisfaction

Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Paulomi (Polly) Burey, Zoe Lynch

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In STEM education, students often have difficulty linking static images and words from textbooks or online resources, to the underlying mechanisms of the topic of study. This can often dissuade some students from pursuing study in the physical and chemical sciences. A growing movement in current day students demonstrates that the YouTube generation feel they learn best from video or dynamic, interactive learning tools, and will seek these out as alternatives to their textbooks and the classroom learning environment. Chemistry, and in particular visualization of molecular structures in everyday materials, can prove difficult to comprehend without significant interaction with the teacher of the content and concepts, beyond the timeframe of a typical class. This can cause a learning hurdle for distance education students, and so it is necessary to provide strong electronic tools and resources to aid their learning. As one of the electronic resources, an animation design approach to link everyday materials to their underlying chemistry would be beneficial for student learning, with the focus here being on food. These animations were designed and storyboarded with a scaling approach and commence with a focus on the food material itself and its component parts. This is followed by animated transitions to its underlying microstructure and identifying features, and finally showing the molecules responsible for these microstructural features. The animation ends with a reverse transition back through the molecular structure, microstructure, all the way back to the original food material, and also animates some reactions that may occur during food processing to demonstrate the purpose of the underlying chemistry and how it affects the food we eat. Using this cyclical approach of linking students’ existing knowledge of food to help guide them to understanding more complex knowledge, and then reinforcing their learning by linking back to their prior knowledge again, enhances student understanding. Food is also an ideal material system for students to interact with, in a hands-on manner to further reinforce their learning. These animations were launched this year in a 2nd year University Food Chemistry course with improved learning outcomes for the cohort.

Keywords: chemistry, food science, future pedagogy, STEM Education

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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Authors: Stanley Fore, Sharon Chipeperekwa

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The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

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Authors: Reynante E. Autida, Maria Ana T. Quimbo

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The chemistry education curriculum provides an excellent avenue where students learn the principles and concepts in chemistry and at the same time, as a central science, better understand related fields. However, the teaching approach used by teachers affects student learning. Cased-based teaching (CBT) is one of the various forms of inductive method. The teacher starts with specifics then proceeds to the general principles. The students’ role in inductive learning shifts from being passive in the traditional approach to being active in learning. In this paper, the effects of Small-Group Case-Based Teaching (SGCBT) on college chemistry students’ achievement, critical thinking, and attitude toward chemistry including the relationships between each of these variables were determined. A quasi-experimental counterbalanced design with pre-post control group was used to determine the effects of SGCBT on Engineering students of four intact classes (two treatment groups and two control groups) in one of the State Universities in Mindanao. The independent variables are the type of teaching approach (SGCBT versus pure lecture-discussion teaching or PLDT) while the dependent variables are chemistry achievement (exam scores) and scores in critical thinking and chemistry attitude. Both Analysis of Covariance (ANCOVA) and t-tests (within and between groups and gain scores) were used to compare the effects of SGCBT versus PLDT on students’ chemistry achievement, critical thinking, and attitude toward chemistry, while Pearson product-moment correlation coefficients were calculated to determine the relationships between each of the variables. Results show that the use of SGCBT fosters positive attitude toward chemistry and provides some indications as well on improved chemistry achievement of students compared with PLDT. Meanwhile, the effects of PLDT and SGCBT on critical thinking are comparable. Furthermore, correlational analysis and focus group interviews indicate that the use of SGCBT not only supports development of positive attitude towards chemistry but also improves chemistry achievement of students. Implications are provided in view of the recent findings on SGCBT and topics for further research are presented as well.

Keywords: case-based teaching, small-group learning, chemistry cases, chemistry achievement, critical thinking, chemistry attitude

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Authors: Roger-Claude Liwanga

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This article reflects on the normative aspects of the jurisprudence on the protection of human rights in times of war that the International Court of Justice (ICJ) developed in 2005 in the Case Concerning Armed Activities on the Territory of the Congo (Democratic Republic of Congo v. Uganda). The article focuses on theories raised in connection with the Democratic Republic of Congo (DRC)'s claim of the violation of human rights of its populations by Uganda as opposed to the violation of its territorial integrity claims. The article begins with a re-visitation of the doctrine of state extraterritorial responsibility for violations of human rights by suggesting that a state's accountability for the breach of its international obligations is not territorially confined but rather transcends the State's national borders. The article highlights the criteria of assessing the State's extraterritorial responsibility, including the circumstances: (1) where the concerned State has effective control over the territory of another State in the context of belligerent occupation, and (2) when the unlawful actions committed by the State's organs on the occupied territory can be attributable to that State. The article also analyzes the ICJ's opinions articulated in DRC v. Uganda with reference to the relationship between human rights law and humanitarian law, and it contends that the ICJ had revised the traditional interaction between these two bodies of law to the extent that human rights law can no longer be excluded from applying in times of war as both branches are complementary rather than exclusive. The article correspondingly looks at the issue of reparations for victims of human rights violations. It posits that reparations for victims of human rights violations should be integral (including restitution, compensation, rehabilitation, satisfaction, and guarantees of non-repetition). Yet, the article concludes by emphasizing that reparations for victims were not integral in DRC v. Uganda because: (1) the ICJ failed to set a reasonable timeframe for the negotiations between the DRC and Uganda on the amount of compensation, resulting in Uganda paying no financial reparation to the DRC since 2005; and (2) the ICJ did not request Uganda to domestically prosecute the perpetrators of human rights abuses.

Keywords: human rights law, humanitarian law, civilian protection, extraterritorial responsibility

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Mona Maria Mombeck

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Social participation in heterogeneous classrooms is one of the main goals in inclusive education. Children with special educational needs (SEN) and children with learning difficulties, or behavioural problems not diagnosed as SEN, are more likely to be excluded by other children than others. It is proven that the presence of dogs, as well as contact with dogs, increases the likelihood of positive social behaviour between humans. Therefore, animal-assisted pedagogy may be presumed to be a constructive way of inclusive teaching and facing the challenges of social inclusion in school classes. This study investigates the presence of a friendly dog in heterogeneous groups of pupils in order to evaluate the influence of dogs on facets of social participation of children in school. 30 German pupils, aged from 10 to 14, in four classes were questioned about their social participation before and after they were educated for a year in school with animal-assisted-pedagogy, using the problem-concerned interview method. In addition, the post-interview includes some general questions about the putative differences or similarities of being educated with and without a dog. The interviews were analysed with the qualitative-content-analysis using QDA software. The results showed that a dog has a positive impact on the atmosphere, student relationships, and well-being in class. Regarding the atmosphere, the pupils mainly argued that the improvement was caused by taking into account the dog’s well-being, respecting the dog-related rules, and by emotional self-regulation. It can be supposed that children regard the rules concerning the dog as more relevant to them than rules, not concerning the dog even if they require the same behaviour and goal. Furthermore, a dog has a positive impact on emotional self-regulation and, therefore, on pupil’s behaviour in class and the atmosphere. In terms of the statements about relationships, the dog’s presence was mainly seen to provide both a unifying aim and a uniting topic to talk about. The improved well-being was described as a feeling of joy and peace of mind. Moreover, the teacher was evaluated as more friendly and trustworthy after animal-assisted teaching. Nevertheless, animal-assisted pedagogy can, rarely, cause problems as well, such as jealousy, distraction, or concerns about the well-being of the dog. The study could prove the relevance of animal-assisted pedagogy for facing the challenges of social participation in inclusive education.

Keywords: animal-assisted-pedagogy, inclusive education, human-animal-interactions, social participation

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Authors: M. F. Wu, F. T. Cheng, C. S. Wu, M. C. Tan

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It is a critical time to upgrade technology and increase value added with manufacturing skills developing and management strategies that will highly satisfy the customers need in the precision machinery global market. In recent years, the supply side, each precision machinery manufacturers in each country are facing the pressures of price reducing from the demand side voices that pushes the high-end precision machinery manufacturers adopts low-cost and high-quality strategy to retrieve the market. Because of the trend of the global market, the manufacturers must take price reducing strategies and upgrade technology of low-end machinery for differentiations to consolidate the market. By using six key success factors (KSFs), customer perceived value, customer satisfaction, customer service, product design, product effectiveness and machine structure quality are causal conditions to explore the impact of competitive advantage of the enterprise, such as overall profitability and product pricing power. This research uses key success paths (KSPs) approach and f/s QCA software to explore various combinations of causal relationships, so as to fully understand the performance level of KSFs and business objectives in order to achieve competitive advantage. In this study, the combination of a causal relationships, are called Key Success Paths (KSPs). The key success paths guide the enterprise to achieve the specific outcomes of business. The findings of this study indicate that there are thirteen KSPs to achieve the overall profitability, sixteen KSPs to achieve the product pricing power and seventeen KSPs to achieve both overall profitability and pricing power of the enterprise. The KSPs provide the directions of resources integration and allocation, improve utilization efficiency of limited resources to realize the continuous vision of the enterprise.

Keywords: precision machinery industry, key success factors (KSFs), key success paths (KSPs), overall profitability, product pricing power, competitive advantages

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Authors: J. Shamash

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The high-school curriculum in algebra deals mainly with the solution of different types of equations. However, modern algebra has a completely different viewpoint and is concerned with algebraic structures and operations. A question then arises: What might be the relevance and contribution of an abstract algebra course for developing expertise and mathematical perspective in secondary school mathematics instruction? This is the focus of this paper. The course Algebra: From Equations to Structures is a carefully designed abstract algebra course for Israeli secondary school mathematics teachers. The course provides an introduction to algebraic structures and modern abstract algebra, and links abstract algebra to the high-school curriculum in algebra. It follows the historical attempts of mathematicians to solve polynomial equations of higher degrees, attempts which resulted in the development of group theory and field theory by Galois and Abel. In other words, algebraic structures grew out of a need to solve certain problems, and proved to be a much more fruitful way of viewing them. This theorems in both group theory and field theory. Along the historical ‘journey’, many other major results in algebra in the past 150 years are introduced, and recent directions that current research in algebra is taking are highlighted. This course is part of a unique master’s program – the Rothschild-Weizmann Program – offered by the Weizmann Institute of Science, especially designed for practicing Israeli secondary school teachers. A major component of the program comprises mathematical studies tailored for the students at the program. The rationale and structure of the course Algebra: From Equations to Structures are described, and its relevance to teaching school algebra is examined by analyzing three kinds of data sources. The first are position papers written by the participating teachers regarding the relevance of advanced mathematics studies to expertise in classroom instruction. The second data source are didactic materials designed by the participating teachers in which they connected the mathematics learned in the mathematics courses to the school curriculum and teaching. The third date source are final projects carried out by the teachers based on material learned in the course.

Keywords: abstract algebra , linking abstract algebra and school mathematics, school algebra, secondary school mathematics, teacher professional development

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Authors: Douglas MacCutcheon, Florian Pausch, Robert Ljung, Lorna Halliday, Stuart Rosen

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Contemporary classrooms are increasingly inclusive of children with mild to moderate disabilities and children from different language backgrounds (bilinguals, multilinguals), but classroom environments and standards have not yet been adapted adequately to meet these challenges brought about by this inclusivity. Additionally, classrooms are becoming noisier as a learner-centered as opposed to teacher-centered teaching paradigm is adopted, which prioritizes group work and peer-to-peer learning. Challenging listening conditions with distracting sound sources and background noise are known to have potentially negative effects on children, particularly those that are prone to struggle with speech perception in noise. Therefore, this research investigates two groups vulnerable to these environmental effects, namely children with a mild to moderate hearing loss (MMHLs) and sequential bilinguals learning in their second language. In the MMHL study, this group was assessed on speech-in-noise perception, and a number of receptive language and cognitive measures (auditory working memory, auditory attention) and correlations were evaluated. Speech reception thresholds were found to be predictive of language and cognitive ability, and the nature of correlations is discussed. In the bilinguals study, sequential bilingual children’s listening comprehension, speech-in-noise perception, listening effort and release from masking was evaluated under a number of different ecologically valid acoustic scenarios in order to pinpoint the extent of the ‘native language benefit’ for Swedish children learning in English, their second language. Scene manipulations included target-to-distractor ratios and introducing spatially separated noise. This research will contribute to the body of findings from which educational institutions can draw when designing or adapting educational environments in inclusive schools.

Keywords: sequential bilinguals, classroom acoustics, mild to moderate hearing loss, speech-in-noise, release from masking

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Authors: Blanco T. F., Fernández-López A.

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Nowadays, education, motivated by the new demands of the 21st century, acquires a dimension that converts the skills that new generations may need into a huge and uncertain set of knowledge too broad to be entirety covered. Within this set, and as tools to reach them, we find Learning and Knowledge Technologies (LKT). Thus, in order to prepare students for an everchanging society in which the technological boom involves everything, it is essential to develop digital competence. Nevertheless LKT seems not to have found their place in the educational system. This work is aimed to go a step further in the research of the most appropriate procedures and resources for technological integration in the classroom. The main objective of this exploratory study is to analyze the didactic suitability (epistemic, cognitive, affective, interactional, mediational and ecological) for teaching and learning processes of mathematics with robotics and 3D printing. The analysis carried out is drawn from a STEAM (Science, Technology, Engineering, Art and Mathematics) project that has the Pilgrimage way to Santiago de Compostela as a common thread. The sample is made up of 25 Primary Education students (10 and 11 years old). A qualitative design research methodology has been followed, the sessions have been distributed according to the type of technology applied. Robotics has been focused towards learning two-dimensional mathematical notions while 3D design and printing have been oriented towards three-dimensional concepts. The data collection instruments used are evaluation rubrics, recordings, field notebooks and participant observation. Indicators of didactic suitability proposed by Godino (2013) have been used for the analysis of the data. In general, the results show a medium-high level of didactic suitability. Above these, a high mediational and cognitive suitability stands out, which led to a better understanding of the positions and relationships of three-dimensional bodies in space and the concept of angle. With regard to the other indicators of the didactic suitability, it should be noted that the interactional suitability would require more attention and the affective suitability a deeper study. In conclusion, the research has revealed great expectations around the combination of teaching-learning processes of mathematics and LKT. Although there is still a long way to go in terms of the provision of means and teacher training.

Keywords: 3D printing, didactic suitability, educational design, robotics

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Authors: Mohsine Jebbour

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The ultimate aim of this study was to analyze a second-year baccalaureate textbook of English to see to what extent it includes elements of critical thinking. A further purpose was to assess the extent to which the teachers’ teaching practices help students develop some degree of critical thinking. The literature on critical thinking indicated that all the writers agree that critical thinking is skilled and dispositional oriented, and most of the definitions highlight the skill and disposition to select, collect, analyze and evaluate information effectively. In this study, two instruments were used, namely content analysis and questionnaire to ensure validity and reliability. The sample of this study, on the one hand, was a second year textbook of English, namely Ticket to English. The process of collecting data was carried out through designing a checklist to analyze the textbook of English. On the other hand, high school students (second baccalaureate grade) and teachers of English constituted the second sample. Two questionnaires were administered—One was completed by 28 high school teachers (18 males and10 females), and the other was completed by 51 students (26 males and 25 females) from Fez, Morocco. The items of the questionnaire tended to elicit both qualitative and quantitative data. An attempt was made to answer two research questions. One pertained to the extent to which the textbooks of English contain critical thinking elements (Critical thinking skills and dispositions, types of questions, language learning strategies, classroom activities); the second was concerned with whether the teaching practices of teachers of English help improve students’ critical thinking. The results demonstrated that the textbooks of English include elements of critical thinking, and the teachers’ teaching practices help the students develop some degree of critical thinking. Yet, the textbooks do not include problem-solving activities and media analysis and 86% of the teacher-respondents tended to skip activities in the textbooks, mainly the units dealing with Project Work and Study Skills which are necessary for enhancing critical thinking among the students. Therefore, the textbooks need to be designed around additional activities and the teachers are required to cover the units skipped so as to make the teaching of critical thinking effective.

Keywords: critical thinking, language learning strategies, language proficiency, teaching practices

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Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Yangyang Zhang

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Martin Eden tells about the tragedy of the protagonist Martin Eden’s suicide after his disillusion about American dream. The author Jack London presents various spatial routines of Martin Eden and reveals the involvement of space in realizing American dream: on the one hand, the Berkeley and Oakland cities contribute to Martin’s material success, making his American dream practical, and on the other hand, the two cities involve in the oppression of bourgeoisie ideology to Martin, promoting the domestic imperialization of bourgeoisie ideology represented by American dream. Molded by bourgeoisie ideology in the city, Martin constructed the oriental South Sea, revealing the oversea imperialization of bourgeoisie ideology behind American dream. By exploring the social, historical and political aspects of space, Martin Eden tries to demonstrate the mere material success and imperialism represented by American dream, revealing the fact of the involvement of American dreamin ideological oppression. When Jack London wrote Martin Eden, he had become a famous writer and realized his personal "American dream". He integrated his struggle experience into the protagonist Martin Eden, and also put his critique of the nature of "American dream" in the novel. The concept of the "American Dream" made the United States the land of dreams, and it also made many Americans believe that through personal struggle, they could climb the social ladder. Under the context of rapid growth in economy in the late 19 th century, American dream was reduced to the satisfaction on a material level. When material wealth was fulfilled, many people felt shattered for a variety of reasons, and such a phenomenon was reflected in the literature of disillusionment in 19th-century America.Martin Eden is such a work about disillusion, in which the geographical space becomes the witness of the realization and disillusionment of the protagonist Martin's "American dream". By analyzing the spatial narrative in Martin Eden, this paper reveals that the "American dream" only represents material success for individuals and the imperialization of capitalist ideology, and exposes the ideological nature of the "American Dream".

Keywords: Martin Eden, space, American dream, ideology of imperialism

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Authors: Elena V. Lysenko

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Motivating as the leading function of a modern Human Resources Management involves issues of increasing the effectiveness of the organization in a broader context. During the formation of motivational systems, the top-management of organization should pay equal attention to both external motivation (incentive system) and internal (self-motivation). The balance of internal and external motivation harmonizes the relations between employers and employees, increases the level of job satisfaction by the organization staff, which in turn leads the organization to success and ensures the organization`s profitability and competitiveness in the market environment. The article is devoted to the study of personnel motivation system in the small metal trade company, which is located in Yekaterinburg, Russian Federation. The study took place during November-December, 2016 ordered by the Company Director to analyze the motivational potential of work (managerial aspect of motivation) and motivation of personnel (personnel aspect of motivation) with the purpose to construct a system of employees’ motivation. The research tools included 6 specially selected tests of motivation, which are: “Motivation profile of your job”, “Constructive motivational attitudes”, Tests about Motivation of achievements (1st variant: Test by А.Mehrabian by the theory of D.С.McClelland and 2nd variant: Test about leading needs according with the theory of D.С.MacClelland), Tests by T.Elers (1st variant: “Determination of the motivation towards success or to avoid failure” and 2nd variant: “Trends to achieve results or to avoid failure”). The results of the study showed only one, but fundamental problem of the whole organization: high level of both motivational potential in work and self-motivation, especially in terms of achievement motivation, but serious lack of productivity. According the results which study showed this problem is derived from insufficient staff competence. The research suggests basic guidelines in order to build the new personnel motivation system for this Company, which is planned to be developed in the nearest future.

Keywords: incentive system, motivation of achievements, motivation system, self-motivation

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Sara Najiazarpour, Mahsa Najiazarpour

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There are many problems in contracting projects and their performance. At each project stage and due to different reasons, these problems affect cost, time and overall project quality. Hence, in order to increase the efficiency and performance in all levels of the chain and with supply chain management approach, there will be a coordination from the beginning of a project (contractor selection) to the end of project (handover of project). Contractor selection is the foremost part of construction projects which in this multi-criteria decision-making, the best contractor is determined by expert judgment, different variables and their priorities. In this paper for selecting the best contractor, numerous criteria were collected by asking from adept experts and then among them, 16 criteria with highest frequency were considered for questionnaire. This questionnaire was distributed between experts. Cronbach's alpha coefficient was obtained as 72%. Then based on Borda's function 12 important criteria was selected which was categorized in four main criteria and related sub-criteria as follow: Environmental factors and physical equipment: procurement and materials (supplier), company's machines, contractor’s proposed cost estimate - financial capacity: bank turnover and company's assets, the income of tax declaration in last year, Ability to compensate for losses or delays - past performance- records and technical expertise: experts and key personnel, the past technical backgrounds and experiences, employer satisfaction of previous contracts, the number of similar projects was done - standards: rank and field of expertise which company is qualified for and its validity, availability and number of permitted projects done. Then with PROMTHEE method, the criteria were normalized and monitored, finally the best alternative was selected. In this research, qualitative criteria of each company is became a quantitative criteria. Finally, information of some companies was evaluated and the best contractor was selected based on all criteria and their priorities.

Keywords: contractor evaluation and selection, project development, supply chain management, PROMTHEE method

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Authors: Madrine King'endo

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This study dealt with the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools in West Embu, Embu County, Kenya. The study purposed to investigate the influence of spelling errors on the English language performance among the class three pupils with dysgraphia in public primary schools. The objectives of the study were to identify the spelling errors that learners with dysgraphia make when writing English words and classify the spelling errors they make. Further, the study will establish how the spelling errors affect the performance of the language among the study participants, and suggest the remediation strategies that teachers could use to address the errors. The study could provide the stakeholders with relevant information in writing skills that could help in developing a responsive curriculum to accommodate the teaching and learning needs of learners with dysgraphia, and probably ensure training of teachers in teacher training colleges is tailored within the writing needs of the pupils with dysgraphia. The study was carried out in Embu county because the researcher did not find any study in related literature review concerning the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools done in the area. Moreover, besides being relatively populated enough for a sample population of the study, the area was fairly cosmopolitan to allow a generalization of the study findings. The study assumed the sampled schools will had class three pupils with dysgraphia who exhibited written spelling errors. The study was guided by two spelling approaches: the connectionist stimulation of spelling process and orthographic autonomy hypothesis with a view to explain how participants with learning disabilities spell written words. Data were collected through interviews, pupils’ exercise books, and progress records, and a spelling test made by the researcher based on the spelling scope set for class three pupils by the ministry of education in the primary education syllabus. The study relied on random sampling techniques in identifying general and specific participants. Since the study used children in schools as participants, voluntary consent was sought from themselves, their teachers and the school head teachers who were their caretakers in a school setting.

Keywords: dysgraphia, writing, language, performance

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Authors: Biniam Bahiru Tufa, Hana Delil Tesfaye, Seife Demisse Legesse, Manaye Tamire

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The healthcare industry is witnessing a digital transformation, with artificial intelligence (AI) offering potential solutions for challenges in health supply chain management (HSCM). However, the adoption of AI in this field remains limited. This research aimed to assess the knowledge, attitude, and practice of AI among students and employees in the health supply chain sector in Ethiopia. Using an explanatory case study research design with a concurrent mixed approach, quantitative and qualitative data were collected simultaneously. The study included 153 participants comprising students and employed health supply chain professionals working in various sectors. The majority had a pharmacy background, and one-third of the participants were male. Most respondents were under 35 years old, and around 68.6% had less than 10 years of experience. The findings revealed that 94.1% of participants had prior knowledge of AI, but only 35.3% were aware of its application in the supply chain. Moreover, the majority indicated that their training curriculum did not cover AI in health supply chain management. Participants generally held positive attitudes toward the necessity of AI for improving efficiency, effectiveness, and cost savings in the supply chain. However, many expressed concerns about its impact on job security and satisfaction, considering it as a burden Graduate students demonstrated higher knowledge of AI compared to employed staff, while graduate students also exhibited a more positive attitude toward AI. The study indicated low previous utilization and potential future utilization of AI in the health supply chain, suggesting untapped opportunities for improvement. Overall, while supply chain experts and graduate students lacked sufficient understanding of AI and its significance, they expressed favorable views regarding its implementation in the sector. The study recommends that the Ethiopian government and international organizations consider introducing AI in the undergraduate pharmacy curriculum and promote its integration into the health supply chain field.

Keywords: knowledge, attitude, practice, supply chain, articifial intellegence

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Authors: Moldir Makenova

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Alongside the implementation of trilingual education in schools, the Ministry of Education and Science of the Republic of Kazakhstan innovated the school curriculum in 2013 to include a Content and Language Integrated Learning (CLIL) approach. In this regard, some transition issues have arisen, such as unprepared teachers, a need for more awareness of the CLIL approach, and teaching resources. Some teachers view it as a challenge due to its combination of both content and language. This often creates anxiety among teachers who are knowledgeable about their subject areas in Kazakh or Russian but are deficient in delivering the subject’s content in English. Thus, with this new teaching approach, teachers encounter to choose the role of language and answer how language works in the CLIL classroom. This study aimed to explore how teachers experience the changing role of language in the curriculum and to find out what challenges teachers face related to CLIL implementation and how their language proficiency influences their teaching practices. A qualitative comparative case study was conducted in an X Lyceum and a mainstream school piloting CLIL. Data collection procedures were conducted via semi-structured interviews, classroom observations, and document analysis. Eight content teachers were chosen from these two schools as the target group of this study. Subject teachers, rather than language teachers, were chosen as the target group to grasp how the language-related issues in the new curriculum are interpreted by educators who do not necessarily identify themselves as language experts at the outset. The findings showed that mainstream teachers prioritize content over language because, as content teachers, the knowledge of content is more essential for them rather than the language. In contrast, most X Lyceum teachers balance language and content and additionally showed their preferences to support the ‘English language only' policy among 10-11 graders. Moreover, due to the low-level English proficiency, mainstream teachers did highlight the necessity of CLIL training and further collaboration with language teachers. This study will be beneficial for teachers and policy-makers to enable them to solve the issues mentioned above related to the implementation of CLIL. Larger-scale research conducted in the future would further inform its successful deployment country-wide.

Keywords: role of language, trilingual education, updated curriculum, teacher practices

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Authors: Cheng Sim Quah, Sandra Phek Lin Sim

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This study examined how individuals in their respective teams contributed to innovation performance besides defining the term of innovation in their own respective views. This study also identified factors that motivated University staff to contribute to the innovation products. In addition, it examined whether there is a significant relationship between professional training level and the length of service among university staff towards innovation and to what extent do the two variables contributed towards innovative products. The significance of this study is that it revealed the strengths and weaknesses of the university staff when contributing to innovation performance. Stratified-random sampling was employed to determine the samples representing the population of lecturers in the study, involving 123 lecturers in one of the local universities in Malaysia. The method employed to analyze the data is through categorizing into themes for the open-ended questions besides using descriptive and inferential statistics for the quantitative data. This study revealed that two types of definition for the term “innovation” exist among the university staff, namely, creation of new product or new approach to do things as well as value-added creative way to upgrade or improve existing process and service to be more efficient. This study found that the most prominent factor that propel them towards innovation is to improve the product in order to benefit users, followed by self-satisfaction and recognition. This implies that the staff in the organization viewed the creation of innovative products as a process of growth to fulfill the needs of others and also to realize their personal potential. This study also found that there was only a significant relationship between the professional training level and the length of service of 4-6 years among the university staff. The rest of the groups based on the length of service showed that there was no significant relationship with the professional training level towards innovation. Moreover, results of the study on directional measures depicted that the relationship for the length of service of 4 - 6 years with professional training level among the university staff is quite weak. This implies that good organization management lies on the shoulders of the key leaders who enlighten the path to be followed by the staff.

Keywords: innovation, length of service, performance, professional training level, motivation

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: L. K. Shitole

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Usually on the face of it, personality is regarded as the external appearance of an individual. In psychology, the personality is not viewed merely as self or external appears, but it adds much more. Human resources development encompasses the personality development of the students. The student’s development starts right from the childhood and gradually continues right up to the completion of education in professional courses. This paper attempts to find out the role of the educational institutions in shaping the personality of the students from the rural area. Schools and colleges have infrastructural limitations, obtaining good quality and devoted teaching staff poses problems and even outside the school environment there are no private classes which may take care of this deficiency. The researcher has used the standardized test namely “Vyaktitva Shodhika” developed by Gyan Prabodhini, Pune for the students in Daund Taluka. There are 68 objective types of questions in the said questionnaire. Totally a sample size of 4191 students was selected. The sample was quite representative. It is observed that by and large the response indicates that the educational institutions are taking sincere efforts in shaping the personality of the students. In the semi-urban area i.e. at educational institutions of all levels, the performance on this front is excellent and at rest of Daund Taluka there is scope for improvement. Educational institutions of all levels are showing excellent performance in ensuring availability of the requisite infrastructure conducive for the development of the personality of the students. In rest of Daund Taluka there is ample scope for improving the situation. As far as data relating to role of co-curricular activities and sports programs in mental and physical development at various educational institutions is concerned Daund educational institutions have repeated their performance in securing “A” category, while in the rural area of Daund Taluka, there is need to step up the efforts in this regard. In today’s world of knowledge industry, one cannot ignore the importance of education and thereby the personality growth of the students. Accordingly, the educational institutions should undertake consistent research and extension activities in the area of personality development.

Keywords: personality, attitude, infrastructure, quality of education, learning environment, teacher’s contribution, family and society’s role

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Authors: Li-hsing Shih, Tzu-hsun Yen

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Because of the long-term commitment to net zero carbon emission, utility companies include more renewable energy supply, which generates electricity with time and weather restrictions. This leads to time-of-use electricity pricing to reflect the actual cost of energy supply. From an end-user point of view, better residential energy management is needed to incorporate the time-of-use prices and assist end users in scheduling their daily use of electricity. This study uses bi-criteria optimization methods to schedule daily energy consumption by minimizing the electricity cost and maximizing the comfort of end users. Different from most previous research, this study schedules users’ activities rather than household appliances to have better measures of users’ comfort/satisfaction. The relation between each activity and the use of different appliances could be defined by users. The comfort level is at the highest when the time and duration of an activity completely meet the user’s expectation, and the comfort level decreases when the time and duration do not meet expectations. A questionnaire survey was conducted to collect data for establishing regression models that describe users’ comfort levels when the execution time and duration of activities are different from user expectations. Six regression models representing the comfort levels for six types of activities were established using the responses to the questionnaire survey. A computer program is developed to evaluate electricity cost and the comfort level for each feasible schedule and then find the non-dominated schedules. The Epsilon constraint method is used to find the optimal schedule out of the non-dominated schedules. A hypothetical case is presented to demonstrate the effectiveness of the proposed approach and the computer program. Using the program, users can obtain the optimal schedule of daily energy consumption by inputting the intended time and duration of activities and the given time-of-use electricity prices.

Keywords: bi-criteria optimization, energy consumption, time-of-use price, scheduling

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Authors: Park Eri, Sklad Marcin, Tsirogianni Stavroula

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In a world where there is increasing exchange and movement of populations groups, and interconnectedness, there are plenty of opportunities for mutual cultural enrichment. However, in everyday life, relations among different cultural groups do not go that smoothly often resulting in discrimination, inequalities and violence. The increasing differentiation of roles, values and worldviews raise a lot of tensions and dilemmas for the state and people -especially in western liberal societies- about issues of acceptance, fairness, justice, autonomy, plurality, freedom, equality and cohesion. Cultural diversity requires a deeper understanding of the roots, meaning and consequences of group differences. We argue, that a psychology from the standpoint of the subject needs to be developed further according to new societal needs. This means within a globalised society, issues regarding the construction of the other as another have become of utmost importance. In constructing the other human beings construct their ideal and possible worlds and meanings about their lives and their significance by drawing on a set of cultural norms, beliefs and values embedded in the different contexts whereby they find themselves in. In this article, we are describing a series of exercises developed in collaboration with University students in the Netherlands that have been piloted with undergraduate 2nd year University Psychology students. These exercises aimed at making tangible and obvious how students apply different moral principles and norms to regulate relationships, which are linked to hegemonic ideological forces. The exercises were in the form of thought experiments that included 8 moral dilemmas, inspired by the moral foundations theory, that touched on different moral principles. The moral dilemmas were built onto each other in incremental steps: from a very tangible/hands-on level to more challenging and demanding ones which require to step into pre-existing networks on knowledge and discourses. After the execution of every dilemma, a discussion followed, which is focused on building links between the ‘theme of the exercise’ and participants’ own lives experiences. In this paper, we provide an evaluation of the methodology used through a discursive analysis of the discussion between the students and the teacher.

Keywords: citizenship, moral dilemmas, social justice, education

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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