Search results for: ESG factors

Authors: Tina Stavredes

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Increasingly borderless learning opportunities including online learning are expanding. Singapore University of Social Science (SUSS) conducted research in February of 2017 to determine the level of consumer interest in undertaking a completely online distance learning degree program across three countries in the Asian Pacific region. The target audience was potential bachelor degree and post-degree students from Malaysia, Indonesia, and Vietnam. The results gathered were used to assess the market size and ascertain the business potential of online degree programs in Malaysia, Indonesia and Vietnam. Secondly, the results were used to determine the most receptive markets to prioritise entry and identify the most receptive student segments. In order to achieve the key outcomes, the key points of understanding were as follows: -Motivations for higher education & factors that influence the choice of institution, -Interest in online learning, -Interest in online learning from a Singapore university relative to other foreign institutions, -Key drivers and barriers of interest in online learning. An online survey was conducted from from 7th Feb 2017 to 27th Feb 2017 amongst n=600 respondents aged 21yo-45yo, who have a basic command of English, A-level qualifications and above, and who have an intent to further their education in the next 12 months. Key findings from the study regarding enrolling in an online program include the need for a marriage between intrinsic and extrinsic motivation factors and the flexibility and support offered in an online program. Overall, there was a high interest for online learning. Survey participants stated they are intrinsically motivated to learn because of their interest in the program of study and the need for extrinsic rewards including opportunities for employment or salary increment in their current job. Seven out of ten survey participants reported they are motivated to further their education and expand their knowledge to become more employable. Eight in ten claims that the feasibility of furthering their education depends on cost and maintaining a work-life balance. The top 2 programs of interest are business and information and communication technology. They describe their choice of university as a marriage of both motivational and feasibility factors including cost, choice, quality of support facilities, and the reputation of the institution. Survey participants reported flexibility as important and stated that appropriate support assures and grows their intent to enrol in an online program. Respondents also reported the importance of being able to work while studying as the main perceived advantage of online learning. Factors related to the choice of an online university emphasized the quality of support services. Despite concerns, overall there was a high interest for online learning. One in two expressed strong intent to enrol in an online programme of study. However, unfamiliarity with online learning is a concern including the concern with the lack of face-to-face interactions. Overall, the findings demonstrated an interest in online learning. A main driver was the ability to earn a recognised degree while still being able to be with the family and the ability to achieve a ‘better’ early career growth.

Keywords: distance education, student motivations, online learning, online student needs

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Margarita Ivanova, Julia Dao, Andrew Friedman, Neil Kasaci, Rekha Gopal, Ozlem Goker-Alpan

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In Fabry disease (FD), α-galactosidase A (α-Gal A) deficiency leads to the accumulation of globotriaosylceramide (Lyso-Gb3 and Gb3), triggering a pathologic cascade that causes the severity of organs damage. The heart is one of the several organs with high sensitivity to the α-Gal A deficiency. A subgroup of patients with significant residual of α-Gal A activity with primary cardiac involvement is occasionally referred to as “cardiac variant.” The cardiovascular complications are most frequently encountered, contributing substantially to morbidity, and are the leading cause of premature death in male and female patients with FD. The deposition of Lyso-Gb-3 and Gb-3 within the myocardium affects cardiac function with resultant progressive cardiovascular pathology. Gb-3 and Lyso-Gb-3 accumulation at the cellular level trigger a cascade of events leading to end-stage fibrosis. In the cardiac tissue, Lyso-Gb-3 deposition is associated with the increased release of inflammatory factors and transforming growth factors. Infiltration of lymphocytes and macrophages into endomyocardial tissue indicates that inflammation plays a significant role in cardiac damage. Moreover, accumulated data suggest that chronic inflammation leads to multisystemic FD pathology even under enzyme replacement therapy (ERT). NF-κB activation plays a subsequent role in the inflammatory response to cardiac dysfunction and advanced heart failure in the general population. TNFalpha/NF-κB signaling protects the myocardial evoking by ischemic preconditioning; however, this protective effect depends on the concentration of TNF-α. Thus, we hypothesize that TNF-α is a critical factor in determining the grade of cardio-pathology. Cardiac hypertrophy corresponds to the expansion of the coronary vasculature to maintain a sufficient supply of nutrients and oxygen. Coronary activation of angiogenesis and fibrosis plays a vital role in cardiac vascularization, hypertrophy, and tissue remodeling. We suggest that the interaction between the inflammatory pathways and cardiac vascularization is a bi-directional process controlled by secreted cytokines and growth factors. The co-coordination of these two processes has never been explored in FD. In a cohort of 40 patients with FD, biomarkers associated with inflammation and cardio hypertrophic remodeling were studied. FD patients were categorized into three groups based on LVmass/DSA, LVEF, and ECG abnormalities: FD with no cardio complication, FD with moderate cardio complication, and severe cardio complication. Serum levels of NF-kB, TNFalpha, Il-6, Il-2, MCP1, ING-gamma, VEGF, IGF-1, TGFβ, and FGF2 were quantified by enzyme-linked immunosorbent assays (ELISA). Among the biomarkers, MCP-1, INF-gamma, VEGF, TNF-alpha, and TGF-beta were elevated in FD patients. Some of these biomarkers also have the potential to correlate with cardio pathology in FD. Conclusion: The study provides information about the role of inflammatory pathways and biomarkers of cardio hypertrophic remodeling in FD patients. This study will also reveal the mechanisms that link intracellular accumulation of Lyso-GB-3 and Gb3 to the development of cardiomyopathy with myocardial thickening and resultant fibrosis.

Keywords: biomarkers, Fabry disease, inflammation, growth factors

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Authors: Nur Hidayah Iwani Mohd Kamal

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The higher education institutions in Malaysia is challenged with a more socially and culturally diverse student population than ever before, especially with the increasing number of international students studying in Malaysia in the recent years. First year university is a critical time in students’ lives. Students are not only developing intelectually, they are also establishing and maintaining personal relationships, developing an identity, deciding about career and lifestyle, maintaining personal health and wellness, and developing an integrated philosohy of life. The higher education institutions work as a diverse community of learners to provide a supportive environment for these first year students in assisting them in their transition from high school to university. Although many universities are taking steps to improve the first year experience for their new local and international students, efforts must be taken to ensure organized and coordinated manner in order for the initiatives to be successful. The objectives of the study are to examine the international students’ perceptions and interpretation of their first year experiences in shaping and determining their attitudes toward study and the quality of their entire undergraduate academic career; and identify an appropriate mechanism to encounter the international students’ adjustment in the new environment in order to facilitate cross-functional communication and create a coherent and meaningful first year experience. A key construct in this study is that if universities wish to recruiting and retaining international students, it is their ethical responsibility to determine how they can best meet their needs at the academic and social level, create a supportive ‘learning community’ as a foundation of their educational experience, hence facilitate cross-cultural communication and create a coherent and meaningful first year experience. This study is simultaneously frames in relation to focus on the factors that influence a successful and satisfying transition to university life by the first year international students. The study employs a mixed-method data collection involving semi-structured interviews, questionnaire, classroom observation and document analysis. This study provides valuable insight into the struggles that many international students face as they attempt to make the adjustment not only to a new educational system but factors such as psychosocial and cultural problems. It would discuss some of the factors that impact the international students during their first year in university in their quest to be academically successful. It concludes with some recommendations on how Malaysian universities provide these students with a good first year experience based on some the best practices of universities around the world.

Keywords: first year experience, Malaysian universities, international students, education

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Authors: Mohamed Mouloud Haddak, Bouthayna Hayou

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Road accidents in French overseas territories have been understudied, with relevant data often collected late and incompletely. Although these territories account for only 3% to 4% of road traffic injuries in France, their unique characteristics merit closer attention. Despite lower mobility and, consequently, lower exposure to road risks, the actual road risk in Overseas France is as high or even higher than in Metropolitan France. Significant disparities exist not only between Metropolitan France and Overseas territories but also among the overseas territories themselves. The varying population densities in these regions do not fully explain these differences, as each territory has its own distinct vulnerabilities and road safety challenges. This analysis, based on BAAC data files from 2005 to 2018 for both Metropolitan France and the overseas departments and regions, examines key variables such as gender, age, type of road user, type of obstacle hit, type of trip, road category, traffic conditions, weather, and location of accidents. Logistic regression models were built for each region to investigate the risk factors associated with fatal road accidents, focusing on the probability of being killed versus injured. Due to insufficient data, Mayotte and the Overseas Communities (French Polynesia and New Caledonia) were not included in the models. The findings reveal that road safety is worse in the overseas territories compared to Metropolitan France, particularly for vulnerable road users such as pedestrians and motorized two-wheelers. These territories present an accident profile that sits between that of Metropolitan France and middle-income countries. A pressing need exists to standardize accident data collection between Metropolitan and Overseas France to allow for more detailed comparative analyses. Further epidemiological studies could help identify the specific road safety issues unique to each territory, particularly with regards to socio-economic factors such as social cohesion, which may influence road safety outcomes. Moreover, the lack of data on new modes of travel, such as electric scooters, and the absence of socio-economic details of accident victims complicate the evaluation of emerging risk factors. Additional research, including sociological and psychosocial studies, is essential for understanding road users' behavior and perceptions of road risk, which could also provide valuable insights into accident trends in peri-urban areas in France.

Keywords: multivariate logistic regression, french overseas regions, road safety, road traffic accidents, territorial inequalities

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Authors: Elif Tugce Aksun Tumerkan, Chris Lowe, Hannah Krupa

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Fluorescent proteins are self-sufficient in forming chromophores with a visible wavelength from 3 amino acids sequence within their own polypeptide structure. This chromophore – a molecule that absorbs a photon of light and exhibits an energy transition equal to the energy of the absorbed photon. Fluorescent proteins (FPs) consisted of a chain of 238 amino acid residues and composed of 11 beta strands shaped in a cylinder surrounding an alpha helix structure. A better understanding of the system of the chromospheres and the increasing advance in protein engineering in recent years, the properties of FPs offers the potential for new applications. They have used sensors and probes in molecular biology and cell-based research that giving a chance to observe these FPs tagged cell localization, structural variation and movement. For clarifying functional uses of fluorescent proteins, electrophoretic properties of these proteins are one of the most important parameters. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) analysis is used for determining electrophoretic properties commonly. While there are many techniques are used for determining the functionality of protein-based research, SDS-PAGE analysis can only provide a molecular level assessment of the proteolytic fragments. Before SDS-PAGE analysis, fluorescent proteins need to successfully purified. Due to directly purification of the target, FPs is difficult from the animal, gene expression is commonly used which must be done by transformation with the plasmid. Furthermore, used gel within electrophoresis and staining agents properties have a key role. In this review, the different factors that have the impact on the electrophoretic properties of fluorescent proteins explored. Fluorescent protein separation and purification are the essential steps before electrophoresis that should be done very carefully. For protein purification, gene expression process and following steps have a significant function. For successful gene expression, the properties of selected bacteria for expression, used plasmid are essential. Each bacteria has own characteristics which are very sensitive to gene expression, also used procedure is the important factor for fluorescent protein expression. Another important factors are gel formula and used staining agents. Gel formula has an effect on the specific proteins mobilization and staining with correct agents is a key step for visualization of electrophoretic bands of protein. Visuality of proteins can be changed depending on staining reagents. Apparently, this review has emphasized that gene expression and purification have a stronger effect than electrophoresis protocol and staining agents.

Keywords: cell biology, gene expression, staining agents, SDS-page

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Authors: Farid Abbasi

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Geographical spaces have different relations with each other, and especially neighboring geographical spaces have more relations than other spaces due to their proximity. Meanwhile, various parameters affect the relationships between these spaces, such as environmental parameters. These parameters have become important in recent decades, affecting the political relations of the actors in neighboring spaces. The Islamic Republic of Iran and the Republic of Turkey, as two actors in the region, political relations seem to have been affected to some extent by environmental issues. Based on this, the present study tries to examine and analyze the political relations between the two countries from an environmental, and geopolitical perspective. The method of this research is descriptive-analytical. The method of data analysis is based on library and field information (questionnaire) in the form of content analysis and statistics through the Mick Mac software system and Scenario Wizard. The results of studies and analysis of theories show that 35 indicators, directly and indirectly, affect Iran-Turkey relations from an environmental, and geopolitical perspective, which are in the form of five dimensions (water resources, soil resources, Vegetation, climate, living species). Using the Mick Mac method, 9 factors were extracted as key factors affecting Iran-Turkey relations, and in the process of analyzing research scenarios, 10100 possible situations were presented by scenario wizard software. 9 strong scenarios with 3 scenarios of favorable and very favorable situations, 3 scenarios with moderate situations and also 3 scenarios with critical situations and catastrophes according to Iran-Turkey relations from the environmental aspect are presented.

Keywords: geopolitics, relations, Iran, Turkey, environment

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Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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Authors: Valentin Nickolai, Florian Pfeffel, Christian Louis Kühner

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In many industrialized nations, the demand for skilled workers rises, causing the current market for employees to be more candidate-driven than employer-driven. Therefore, losing highly skilled and experienced employees due to early or partial retirement negatively impacts firms. Therefore, finding new ways to incentivize older employees (Silver Workers) to stay longer with the company and in their job can be crucial for the success of a firm. This study analyzes how working remotely can be a valid incentive for experienced Silver Workers to stay in their job and instead work from home with more flexible working hours. An online survey with n = 684 respondents, who are employed in the service sector, has been conducted based on 13 constructs that influence job satisfaction. These have been further categorized into three groups “classic influencing factors,” “influencing factors changed by remote working,” and new remote working influencing factors,” and were analyzed using structural equation modeling (SEM). Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. Additionally, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). It was shown in the SEM-analysis that the influencing factor on job satisfaction, “identification with the work,” is the most significant with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis also shows that the identification with the work is the most significant factor in all three work models mentioned above and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that employees between the ages of 56 and 65 years have the highest job satisfaction when working entirely from home or remotely. Furthermore, their job satisfaction score of 5.4 on a scale from 1 (very dissatisfied) to 7 (very satisfied) is the highest amongst all age groups in any of the three work models. Due to the significantly higher job satisfaction, it can be argued that giving Silver Workers the offer to work from home or remotely can incentivize them not to opt for early retirement or partial retirement but to stay in their job full-time Furthermore, these findings can indicate that employees in the Silver Worker age are much more inclined to leave their job for early retirement if they have to entirely work in the office.

Keywords: home office, remote work instead of early or partial retirement, silver worker, structural equation modeling

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Authors: Camila Amin-Puello, Lina Vasco-Diaz, Juan Ramirez-Arias, Claudia Munoz, Carlos Gonzalez-Calderon

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Operational flexibility is a fundamental aspect in the field of airlines because although demand is constantly changing, it is the duty of companies to provide a service to users that satisfies their needs in an efficient manner without sacrificing factors such as comfort, safety and other perception variables. The objective of this research is to understand the factors that describe and explain operational flexibility by implementing advanced analytical methods such as exploratory factor analysis and structural equation modeling, examining multiple levels of operational flexibility and understanding how these variable influences users' decision-making when choosing an airline and in turn how it affects the airlines themselves. The use of a hybrid model and latent variables improves the efficiency and accuracy of airline performance prediction in the unpredictable Colombian market. This pioneering study delves into traveler motivations and their impact on domestic flight demand, offering valuable insights to optimize resources and improve the overall traveler experience. Applying the methods, it was identified that low-cost airlines are not useful for flexibility, while users, especially women, found airlines with greater flexibility in terms of ticket costs and flight schedules to be more useful. All of this allows airlines to anticipate and adapt to their customers' needs efficiently: to plan flight capacity appropriately, adjust pricing strategies and improve the overall passenger experience.

Keywords: hybrid choice model, airline, business travelers, domestic flights

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Authors: Mohammed Alhamed

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This research examines the factors influencing the acceptance and adoption of digital technologies in Saudi Arabia’s government sector by focusing on government employees' attitudes toward digital transformation initiatives. As digital technologies increasingly integrate into public sectors worldwide, there is a requirement to enhance citizen empowerment and government-public interactions as well as understand their impact in unique socio-political contexts like Saudi Arabia. The study aims to explore user attitudes, identify the main challenges, and investigate factors that affect the intention to use digital applications in governmental settings. The study employs a mixed-methods approach by combining quantitative and qualitative data collection to provide a comprehensive view of digital government application adoption. Data was collected through two online surveys administered to 870 government employees and face-to-face semi-structured interviews with 24 participants. This dual approach allows for both statistical analysis and thematic exploration, which provides a deeper understanding of user behaviour, perceived benefits, challenges and attitudes toward these digital applications. Quantitative data were analyzed to identify significant variables influencing adoption, while qualitative responses were coded thematically to uncover recurring themes related to user trust, security, usability and socio-political influences. The results indicate that digital government applications are largely valued for their ability to increase efficiency and accessibility and streamline processes like online documentation and inter-departmental coordination. However, the study highlights that security, privacy, and confidentiality concerns constitute substantial barriers to adoption, with participants calling for stronger cybersecurity measures and data protection policies. Moreover, usability emerged as a key theme that intuitively interfaces in encouraging adoption as respondents emphasized the importance of user-friendly. Additionally, the study found that Saudi Arabia’s unique cultural and organizational dynamics impact acceptance levels with factors like hierarchical structures and varying levels of digital literacy shaping user attitudes. A significant limitation of the study is its exclusive focus on government employees, which may limit the generalizability of the findings to other stakeholder groups, such as the general public. Despite this, the study offers valuable views for policymakers. This, in turn, suggests best practices and guidelines that could enhance the design and implementation of digital government projects. By addressing the identified barriers and leveraging the factors that drive adoption, the study underscores the potential for digital government initiatives to improve efficiency, transparency and responsiveness in Saudi Arabia's public sector. Furthermore, these findings may provide a roadmap for similar countries aiming to adopt digital government solutions within comparable socio-political and economic contexts.

Keywords: acceptance, adoption, digital technologies, digital government, Saudi Arabia

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Authors: Dainius Genys, Vylius Leonavicius, Ricardas Krikstolaitis

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Energy security problems in Lithuania are analyzed on a regular basis; however, there is no comprehensive research on the very issue of the concept of public energy security. There is a lack of attention not only to social determinants of perception of energy security, but also a lack of a deeper analysis of the public opinion. This article aims to research the Lithuanian public perception of energy security. Complex tasks were set during the sociological study. Survey questionnaire consisted of different sets of questions: view of energy security (risk perception, political orientation, and energy security; comprehensiveness and energy security); view of energy risks and threats (perception of energy safety factors; individual dependence and burden; disobedience and risk); view of the activity of responsible institutions (energy policy assessment; confidence in institutions and energy security), demographic issues. In this article, we will focus on two aspects: a) We will analyze public opinion on the most important aspects of energy security and social factors influencing them; The hypothesis is made that public perception of energy security is related to value orientations: b) We will analyze how public opinion on energy policy executed by the government and confidence in the government are intertwined with the concept of energy security. Data of the survey, conducted on May 10-19 and June 7-17, 2013, when Seimas and the government consisted of the coalition dominated by Social Democrats with Labor, Order and Justice Parties and the Electoral Action of Poles, were used in this article. It is important to note that the survey was conducted prior to Russia’s occupation of the Crimea.

Keywords: energy security, public opinion, risk, energy threat, energy security policy

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Authors: Nanteza Rachel

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Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

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Authors: V. A. Dubovsky, V. V. Savchenko, A. A. Baryskevich

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The current trend in the automotive industry towards automatic vehicles is creating new challenges related to human factors. This occurs due to the fact that the driver is increasingly relieved of the need to be constantly involved in driving the vehicle, which can negatively impact his/her situation awareness when manual control is required, and decrease driving skills and abilities. These new problems need to be studied in order to provide road safety during the transition towards self-driving vehicles. For this purpose, it is important to develop an appropriate conceptual model of the interaction between the driver and the automated vehicle, which could serve as a theoretical basis for the development of mathematical and simulation models to explore different aspects of driver behaviour in different road situations. Well-known driver behaviour models describe the impact of different stages of the driver's cognitive process on driving performance but do not describe how the driver controls and adjusts his actions. A more complete description of the driver's cognitive process, including the evaluation of the results of his/her actions, will make it possible to more accurately model various aspects of the human factor in different road situations. This paper presents a conceptual model of the 'driver – highly automated vehicle' system based on the P.K. Anokhin's theory of functional systems, which is a theoretical framework for describing internal processes in purposeful living systems based on such notions as goal, desired and actual results of the purposeful activity. A central feature of the proposed model is a dynamic coupling mechanism between the decision-making of a driver to perform a particular action and changes of road conditions due to driver’s actions. This mechanism is based on the stage by stage evaluation of the deviations of the actual values of the driver’s action results parameters from the expected values. The overall functional structure of the highly automated vehicle in the proposed model includes a driver/vehicle/environment state analyzer to coordinate the interaction between driver and vehicle. The proposed conceptual model can be used as a framework to investigate different aspects of human factors in transitions between automated and manual driving for future improvements in driving safety, and for understanding how driver-vehicle interface must be designed for comfort and safety. A major finding of this study is the demonstration that the theory of functional systems is promising and has the potential to describe the interaction of the driver with the vehicle and the environment.

Keywords: automated vehicle, driver behavior, human factors, human-machine system

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Authors: Davoud Mokhtari

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One of the factors behind the increasing development of geotourism is the identification and introduction of new facets of amazing geosphere phenomena. The Misho-Dagh Mountains in northwestern Iran are one of the rich geodiversity areas. The presence of some rare and interesting phenomena in this mountain has increased the potential of this region for geotourism development. Active pressure ridges, arcuate valleys, sag Ponds, granite complexes, glacial rock springs, and displaced habitats due to tectonic activity are among the most significant phenomena in the study area. The research is based on the literature review of geotourism and personal research experiences on geomorphosites of the northwest of Iran. Monitoring the changes of geomorphosites and evaluation of corresponding changes in the geomorphosite̕s location and their capabilities using satellite images and fieldwork is done. In this study, six geomorphosite were introduced, each with special characteristics and with one of the geotourism topics. Selection of this location of northwestern Iran is due to the focus of author of this paper is on this part of the country, and there is no doubt that such places, even with higher values of geotourism, there are in various parts of Iran and the world that could be interested in this field of emerging science. From in situ observations taken in the field and estimating a level of impact, employing assessment techniques, and then finally extrapolating the resultant factors across all case studies, we have been able to generate a geotourism map for future planning purposes. Accordingly, it should be noted that we are not just part of the landscape of the geomorphosites. The geomorphosites are also part of our landscape. It is hoped that the findings of this paper can open a new world of geotourism that, if is not associated with geomorphological processes, will be very short.

Keywords: geotourism, sources of geotourism, geotouristic areas, mishow_dagh, northwest of Iran

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Authors: Mohammed Aman Kassim

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This study explored the attitudes of hotel managers toward climate change adaption and mitigation practices in resort hotels located in Bishoftu town, Ethiopia. Weak resource management in the area causes serious environmental problems. So sustainable way forward is needed for the destination in order to reduce environmental damage. Six resorts were selected out of twelve resort hotels in Bishoftu City by using the systematic sampling method, and a total of fifty-six managers were taken for the study. The data analyzed came from self-administered questionnaires, site observation, and a short face-to-face interview with general managers. The results showed that 99% of hotel managers possess positive attitudes toward climate change adaptation and mitigation practices. But they did not show a high commitment to adopting all adaptation and mitigation practices in their hotel’s actions and day-to-day operation. Key adoption influencing factors identified were: owners' commitment toward sustainability, the applicability of government rules and regulations, and incentives for good achievement. The findings also revealed that the attitudes of resort hotel managers toward climate change adaption and mitigation practices are more significantly influenced by their social factors, such as level of education and age, in this study. The study demonstrated that in order to increase managers' commitment and hotels become green: government led-education and training programs, green certification actions, and application of government environmental regulation are important.

Keywords: climate change, climate change adaptation and mitigation practices, environmental attitude, resort hotels

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Authors: Chong-Yang Qiao

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Mobile augmented reality (MAR) tracking targets from the surroundings and aids operators for interactive data and procedures visualization, potential equipment and system understandably. Operators remotely communicate and coordinate with each other for the continuous tasks, information and data exchange between control room and work-site. In the routine work, distributed control system (DCS) monitoring and work-site manipulation require operators interact in real-time manners. The critical question is the improvement of user experience in cooperative works through applying Augmented Reality in the traditional industrial field. The purpose of this exploratory study is to find the cognitive model for the multiple task performance by MAR. In particular, the focus will be on the comparison between different tasks and environment factors which influence information processing. Three experiments use interface and interaction design, the content of start-up, maintenance and stop embedded in the mobile application. With the evaluation criteria of time demands and human errors, and analysis of the mental process and the behavior action during the multiple tasks, heuristic evaluation was used to find the operators performance with different situation factors, and record the information processing in recognition, interpretation, judgment and reasoning. The research will find the functional properties of MAR and constrain the development of the cognitive model. Conclusions can be drawn that suggest MAR is easy to use and useful for operators in the remote collaborative works.

Keywords: mobile augmented reality, remote collaboration, user experience, cognition model

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Authors: Marie Taylor, Catriona Murphy

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The aim of this paper is to identify the factors of success in community based heritage tourism initiatives. Heritage and community are central to many tourism initiatives with heritage tourism having the potential to act as a catalyst for community development. This paper presents the findings of research that examined the relationship between heritage tourism and community development. The findings recognised that heritage tourism had economic, social and cultural benefits for a community as well as a role in strengthening concepts such as sense of identity, place, and authenticity. In addition, this paper proposes an assessment framework for sustainable community based heritage tourism to identify factors and contextual influences involved in their success or failure. In evaluating the sustainability of such initiatives, a number of issues are investigated including the continued role of stakeholders, the role of funding, the influence of collaboration and the changing role of rural development and its impact on community engagement. The research is descriptive, evaluative and explanatory research, exploring and analysing issues such as the development of community structures in community based heritage tourism. Thus, it will contribute to the development of potential tourism and community development policies and strategies at a local, national and international level. An interpretative and inductive approach is utilised, and a mixed method approach followed as it encapsulates the best of quantitative and qualitative research methods. The case studies focus on social enterprises in relation to tourism and community based tourism cooperatives as there are limited study and knowledge of these. Consequently, this research will contribute to the discourse on community based heritage tourism as an aspect of community development.

Keywords: collaboration, community-based heritage tourism, stakeholders, sustainable tourism

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Authors: Muhammed Kök & Adem Kantar

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Learning a foreign language can be affected by various factors such as age, aptitude, motivation, L2 disposition, etc. Among these factors, masculine gender roles stress (MGRS) that male learners possess is the least touched area that has been examined so far.MGRS can be defined as the traditional male role stress when the male learners feel the masculinity threat against their traditionally adopted masculinity norms. Traditional masculine norms include toughness, accuracy, completeness, and faultlessness. From this perspective, these norms are diametrically opposed to the language learning process since learning a language, by its nature, involves stages such as making mistakes and errors, not recalling words, pronouncing sounds incorrectly, creating wrong sentences, etc. Considering the potential impact of MGRS on the language learning process, the main purpose of this study is to investigate the mediating role of MGRS on the relationship between the EFL learners’ self-disclosure and English class anxiety. Data were collected from Turkish EFL learners (N=282) who study different majors in various state universities across Turkey. Data were analyzed by means of the Bootstraping method using the SPSS Process Macro plugin. The findings show that the indirect effect of self-disclosure level on the English Class Anxiety via MGRS was significant. We conclude that one of the reasons why Turkish EFL learners have English class anxiety might be the pressure that they feel because of their traditional gender role stress.

Keywords: masculine, gender role stress, english class anxiety, self-disclosure, masculinity norms

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Authors: Bongs Lainjo

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The evolution and escalation of bike-sharing programs (BSP) continue unabated. Since the sixties, many countries have introduced different models and strategies of BSP. These include variations ranging from dockless models to electronic real-time monitoring systems. Reasons for using this BSP include recreation, errands, work, etc. And there is all indication that complex, and more innovative rider-friendly systems are yet to be introduced. The objective of this paper is to analyze current variables established by different operators and streamline them identifying the most compelling ones using analytics. Given the contents of available databases, there is a lack of uniformity and common standard on what is required and what is not. Two factors appear to be common: user type (registered and unregistered, and duration of each trip). This article uses historical data provided by one operator based in the greater Washington, District of Columbia, USA area. Several variables including categorical and continuous data types were screened. Eight out of 18 were considered acceptable and significantly contribute to determining a useful and reliable predictive model. Bike-sharing systems have become popular in recent years all around the world. Although this trend has resulted in many studies on public cycling systems, there have been few previous studies on the factors influencing public bicycle travel behavior. A bike-sharing system is a computer-controlled system in which individuals can borrow bikes for a fee or free for a limited period. This study has identified unprecedented useful, and pragmatic parameters required in improving BSP ridership dynamics.

Keywords: sharing program, historical data, parameters, ridership dynamics, trip duration

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Authors: Mariella Pinna

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Sustainable entrepreneurship is an innovative corporate approach to create value combining economic, social and environmental goals over time. In the last two decades, the interest in sustainable entrepreneurship has flourished thanks to its potential to answer the current challenges of sustainable development. As a result, scholars are increasingly interested in understanding the determinants of the intentions to become a sustainable entrepreneur and consistent behavior. To date, prior studies provided empirical evidence for the influence of attitudes, perceived feasibility and desirability, values, and personality traits on the decision-making process of becoming a sustainable entrepreneur. Conversely, scant effort has been provided to understand which factors inhibit sustainable entrepreneurial intentions and behaviors. Therefore a global understanding of the sustainable entrepreneurship decision-making process is missing. This paper contributes to the debate on sustainable entrepreneurship by proposing a conceptual model that combines the factors which are predicted to facilitate and hinder the proclivity of individuals to become sustainable entrepreneurs. More in particular, the proposed framework theorizes about the role of the characteristics of the prospective sustainable entrepreneur (e.g., socio-demographic, psychological, cultural), the positive antecedents (e.g., attitude, social feasibility and desirability, among others) and the negative precursors (e.g., neutralization) in influencing sustainable entrepreneurship intentions and subsequent behavior. The proposed framework is expected to shed further light on the decision-making process of becoming a sustainable entrepreneur, which in turn, is of practical relevance for public policy institutions and the society as a whole to enhance the favorable conditions to create new sustainable ventures.

Keywords: sustainable entrepreneurship, entrepreneurial intentions, entrepreneurial decision-making, antecedents of entrepreneurial intention and behavior

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Authors: Rakesh Kumar, Fatima Electricwala

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One of the major thrusts of the Bus Rapid Transit System is to reduce the commuter’s dependency on private vehicles and increase the shares of public transport to make urban transportation system environmentally sustainable. In this study, commuter mode choice analysis is performed that examines behavioral responses to the proposed Bus Rapid Transit System (BRTS) in Surat, with estimation of the probable shift from private mode to public mode. Further, evaluation of the BRTS scenarios, using Surat’s transportation ecological footprint was done. A multi-modal simulation model was developed in Biogeme environment to explicitly consider private users behaviors and non-linear environmental impact. The data of the different factors (variables) and its impact that might cause modal shift of private mode users to proposed BRTS were collected through home-interview survey using revealed and stated preference approach. A multi modal logit model of mode-choice was then calibrated using the collected data and validated using proposed sample. From this study, a set of perception factors, with reliable and predictable data base, to explain the variation in modal shift behaviour and their impact on Surat’s ecological environment has been identified. A case study of the proposed BRTS connecting the Surat Industrial Hub to the coastal area is provided to illustrate the approach.

Keywords: BRTS, private modes, mode choice models, ecological footprint

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Authors: Jyoti Srivastava, Sandhya S. Kaushik, Mallika Tewari, Hari S. Shukla

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Little information is available about the development of psychological well being over time among women who have been undergoing treatment for breast cancer. The aim of this study was to identify the trajectories of depression anxiety and stress among women with early-stage breast cancer. Of the 48 Indian women with newly diagnosed early-stage breast cancer recruited from surgical oncology unit, 39 completed an interview and were assessed for depression anxiety and stress (Depression Anxiety Stress Scale-DASS 21) before their first course of chemotherapy (baseline) and follow up interviews at 3, 6 and 9 months thereafter. Growth mixture modeling was used to identify distinct trajectories of Depression Anxiety and Stress symptoms. Logistic Regression analysis was used to evaluate the characteristics of women in distinct groups. Most women showed mild to moderate level of depression and anxiety (68%) while normal to mild level of stress (71%). But one in 11 women was chronically anxious (9%) and depressed (9%). Young age, having a partner, shorter education and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong nine months after diagnosis. By looking beyond the mean, it was found that several socio-demographic and treatment factors characterized the women whose depression, anxiety and stress level remained severe even nine months after diagnosis. The results suggest that support provided to cancer patients should have a special focus on a relatively small group of patient most in need.

Keywords: psychological well being, growth mixture modeling, logistic regression analysis, socio-demographic factors

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Authors: Muhammad Abdullah, Salman Iqbal, Mamoona Rasheed

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Social identity among people is an important source of pride and self-esteem, consequently, people struggle to preserve a positive perception of their groups and collectives. The purpose of this paper is to explain the process of social identification and to highlight the underlying causal factors of social identity among employees. There is a little research about how the social identity of employees is shaped in Pakistan’s organizational culture. This study is based on social identity theory. This study uses Systems’ approach as a research methodology. The feedback loop approach is applied to explain the underlying key elements of employee behavior that collectively form social identity among social groups in corporate arena. The findings of this study reveal that effective, evaluative and cognitive components of an individual’s personality are associated with the social identification. The system dynamic feedback loop approach has revealed the underlying structure that is associated with social identity, social group formation, and effective component proved to be the most associated factor. This may also enable to understand how social groups become stable and individuals act according to the group requirements. The value of this paper lies in the understanding gained about the underlying key factors that play a crucial role in social group formation in organizations. It may help to understand the rationale behind how employees socially categorize themselves within organizations. It may also help to design effective and more cohesive teams for better operations and long-term results. This may help to share knowledge among employees as well. The underlying structure behind the social identification is highlighted with the help of system modeling.

Keywords: affective commitment, cognitive commitment, evaluated commitment, system thinking

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Authors: Achim Kampker, Christoph Deutskens, Heiner Hans Heimes, Mathias Ordung, Felix Optehostert

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In the past years electric mobility became part of a public discussion. The trend to fully electrified vehicles instead of vehicles fueled with fossil energy has notably gained momentum. Today nearly every big car manufacturer produces and sells fully electrified vehicles, but electrified vehicles are still not as competitive as conventional powered vehicles. As the traction battery states the largest cost driver, lowering its price is a crucial objective. In addition to improvements in product and production processes a non-negligible, but widely underestimated cost driver of production can be found in logistics, since the production technology is not continuous yet and neither are the logistics systems. This paper presents an approach to evaluate cost factors on different designs of load carrier systems. Due to numerous interdependencies, the combination of costs factors for a particular scenario is not transparent. This is effecting actions for cost reduction negatively, but still cost reduction is one of the major goals for simultaneous engineering processes. Therefore a concurrent and phase appropriate cost valuation method is necessary to serve cost transparency. In this paper the four phases of this cost valuation method are defined and explained, which based upon a new approach integrating the logistics development process in to the integrated product and process development.

Keywords: research and development, technology and innovation, lithium-ion-battery production, load carrier development process, cost valuation method

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Authors: Xiaoxue Jin, Qiong Zhang

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The rapid influx and ongoing flow of young migrants in large cities, alongside the emergence and evolution of new social media, have led to increased interpersonal alienation and weakened place attachment. In the interplay between individuals and space, urban public spaces play a pivotal role in meeting the multifaceted needs of individuals and fostering a sense of attachment. This article aims to investigate the relationship between the place characteristics of public spaces and individuals' needs and perceptions, with an aim to identify the factors influencing place attachment among the youth. This study is conducted in the Shekou community of Shenzhen, focusing on the youth residents to evaluate their place attachment levels and to analyze their perceptions of the place characteristics of selected public spaces. The influencing factors of public spaces on place attachment were sorted out through detailed data analysis. Research has found that rapid urbanization has led to spatial homogenization and spatial segregation caused by uneven resource distribution, which in turn diminishes the utilization of public spaces. The social characteristics of public spaces, such as the quality of social activities and spatial openness, are critical in forming place attachment. In this research, place characteristics impacting place attachment are categorized, aiming to reconstruct the characteristics of public space places and use them as a medium to explore the place attachment of young people, promote their independent creation and participation in public life, and enhance the dynamism between individuals and spaces.

Keywords: place attachment, place characteristics, public spaces, spatial perception

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Authors: Jae Hyun Park, Sangmi Chai, Minkyun Kim

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As users spend more time on the Internet, the probability of their personal information being exposed has been growing. This research has a main purpose of investigating factors and examining relationships when Internet users recognize their value of private information with a perspective of an economic asset. The study is targeted on Internet users, and the value of their private information will be converted into economic figures. Moreover, how economic value changes in relation with individual attributes, dealer’s traits, circumstantial properties will be studied. In this research, the changes in factors on private information value responding to different situations will be analyzed in an economic perspective. Additionally, this study examines the associations between users’ perceived risk and value of their personal information. By using the cost-benefit analysis framework, the hypothesis that the user’s sense in private information value can be influenced by individual attributes and situational properties will be tested. Therefore, this research will attempt to provide answers for three research objectives. First, this research will identify factors that affect value recognition of users’ personal information. Second, it provides evidences that there are differences on information system users’ economic value of information responding to personal, trade opponent, and situational attributes. Third, it investigates the impact of those attributes on individuals’ perceived risk. Based on the assumption that personal, trade opponent and situation attributes make an impact on the users’ value recognition on private information, this research will present the understandings on the different impacts of those attributes in recognizing the value of information with the economic perspective and prove the associative relationships between perceived risk and decision on the value of users’ personal information. In order to validate our research model, this research used the regression methodology. Our research results support that information breach experience and information security systems is associated with users’ perceived risk. Information control and uncertainty are also related to users’ perceived risk. Therefore, users’ perceived risk is considered as a significant factor on evaluating the value of personal information. It can be differentiated by trade opponent and situational attributes. This research presents new perspective on evaluating the value of users’ personal information in the context of perceived risk, personal, trade opponent and situational attributes. It fills the gap in the literature by providing how users’ perceived risk are associated with personal, trade opponent and situation attitudes in conducting business transactions with providing personal information. It adds to previous literature that the relationship exists between perceived risk and the value of users’ private information in the economic perspective. It also provides meaningful insights to the managers that in order to minimize the cost of information breach, managers need to recognize the value of individuals’ personal information and decide the proper amount of investments on protecting users’ online information privacy.

Keywords: private information, value, users, perceived risk, online information privacy, attributes

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Authors: Sylvanus N. Wosu

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Research shows that factors, such as low motivation, preparation, resources, emotional and social integration, and fears of risk-taking, are the most common barriers to access, matriculation, and retention into science, technology, engineering, and mathematics (STEM) disciplines for underrepresented (URM) students. These factors have been shown to impact students’ attraction and success in STEM fields. Standardized tests such as the SAT and ACT often used as predictor of success, are not always true predictors of success for African and Hispanic American students. Without an adequate academic support environment, even a high SAT score does not guarantee academic success in science and engineering. This paper proposes a model for Academic Coaching for building success and inclusive excellence in STEM education. Academic coaching is framed as a process of motivating students to be independent learners through relational mentorship, facilitating learning supports inside and outside of the classroom or school environment, and developing problem-solving skills and success attitudes that lead to higher performance in the specific subjects. The model is formulated based on best strategies and practices for enriching Academic Performance Impact skills and motivating students’ interests in STEM. A scaled model for measuring the Academic Performance Impact (API) index and STEM is discussed. The study correlates API with state standardized test and shows that the average impact of those skills can be predicted by the Academic Performance Impact (API) index or Academic Preparedness Index.

Keywords: diversity, equity, graduate education, inclusion, inclusive excellence, model

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Authors: Abonyi, Emmanuel Ebuka, Amina Jafaru O.

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Background: Illicit substance use among students is a phenomenon that has been widely studied, but it remains of interest due to its high prevalence and potential consequences. It is a major mental health concern among university students which may result in behavioral and academic problems, psychiatric disorders, and infectious diseases. Thus, this study was done to ascertain the prevalence and factors associated with the use of illicit drugs among these groups of people. Methods: A cross-sectional and descriptive survey was conducted among undergraduate students of the University of Lagos for the duration of three(3) months (August to October 2021). A total number of 938 undergraduate students were selected from seventeen faculties in the university. Pretested questionnaires were administered, completed, and returned. The data were analyzed using descriptive statistics and multivariate regression analysis. Results: From the data collected, it was observed that out of 938 undergraduate students of the University of Lagos that completed and returned the questionnaires, 56.3% were female and 43.7% were male. No gender differences were observed in the prevalence of use of any of the illicit substances. The result showed that the majority of the students that participated in the research were females(56.6%); it was observed that there were a total of 541 2nd-year students(57.7%) and 397 final-year students(42.3). Students between the age brackets of 20- 24 years had the highest frequency of 648(69.1%) of illicit drug use and students in none health-related disciplines. The result also showed that the majority of the students reported that they use Marijuana (31.7%), while lifetime use of LSD (6.3%), Heroin(4.8%), Cocaine (4.7%), and Ecstasy(4.5), Ketamine (3.4%). Besides, the use of alcohol was below average(44.1%). Additionally, Marijuana was among the ones that were mostly taken by students having a higher percentage and most of these respondents had experienced relationship problems with their family and intentions (50.9%). From the responses obtained, major reasons students indulge in illicit drug use were; curiosity to experiment, relief of stress after rigorous academic activities, social media influence, and peer pressure. Most Undergraduate students are in their most hyperactive stage in life, which makes them vulnerable to always want to explore practically every adventure. Hence, individual factors and social media influence are identified as major contributors to the prevalence of illicit drug use among undergraduate students at the University of Lagos, Nigeria. Conclusion: Control programs are most needed among the students. They should be comprehensive and focused on students' psycho-education about substances and their related negative consequences, plus the promotion of students' life skills, and integration into the family – and peer-based preventive interventions.

Keywords: illicit drugs, addiction, undergraduate students, prevalence, substances

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Depression has emerged as a growing public health issue, with the limited effectiveness of current treatment methods driving the search for modifiable lifestyle factors. Physical inactivity and poor dietary habits are consistently identified as factors associated with increased depression symptoms. While the independent effects of physical activity (PA) and dietary quality (DQ) on mental health are well established, the combined influence of both factors on depression has not been thoroughly examined in a representative sample of U.S. adults. This study aims to explore the individual and joint associations of PA and DQ with depression symptoms, highlighting their combined impact on adults across the U.S. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020, we evaluated the relationships between PA (measured through metabolic equivalent (MET) minutes per week) and DQ (assessed using the Healthy Eating Index [HEI]-2015) and depression symptoms (defined by a score of ≥10 on the 9-item Patient Health Questionnaire [PHQ-9]). Participants were classified into four lifestyle categories: (1) healthy diet and active, (2) unhealthy diet but active, (3) healthy diet but inactive, and (4) unhealthy diet and inactive. Logistic regression models adjusted for relevant covariates were used to examine associations, with age-adjusted prevalence rates for depression calculated according to NHANES guidelines. Data from 21,530 participants, representing approximately 954 million U.S. adults aged 20-80 years, were analyzed. The overall age-adjusted prevalence of depression symptoms was 7.15%. A total of 83.1% of participants met PA recommendations, and 27.3% scored above the 60th percentile in the HEI-2015 index. Higher PA levels were inversely related to depression symptoms (adjusted odds ratio [AOR]: 0.805; 95% CI: 0.724-0.920), as was better dietary quality (AOR: 0.788; 95% CI: 0.690-0.910). A combination of healthy diet and adequate PA was associated with the lowest risk of depression symptoms (AOR: 0.635; 95% CI: 0.520-0.775) compared to inactive participants with unhealthy diets. Notably, participants with either a healthy diet or adequate PA but not both did not experience the same reduction in depression risk. This study highlights that the combination of a healthy diet and regular physical activity offers a synergistic protective effect against depression symptoms in U.S. adults. Public health initiatives targeting both dietary improvements and increased physical activity may significantly reduce the burden of depression across populations. Further research should focus on understanding the mechanisms underlying these interactions.

Keywords: dietary quality, physical activity, depression, healthy eating

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