Adjustment Issues Research Articles

PRE-KINDERGARTEN TRANSITION PROGRAM (PTP) FOR CHILD DEVELOPMENT WORKERS (CDWs)

Utilizing the descriptive research design, integrating the Research & Development (R&D) methodology, this study developed the Pre-kindergarten Transition Program (PTP) for Child Development Workers (CDWs) based on the identified factors that affect common adjustment issues of pre-kindergartners and the various experiences of CDWs in handling adjustment issues during the transition period. The study was conducted in the five districts of Child Development Centers (CDCs) in Laoag City. Using a purposive sampling technique, this study involved 19 CDWs and three experts in the field of early childhood education (ECE). A structured interview guide for the Focus Group discussion (FGD) and a validation tool adapted from Valdez (2023) were used in gathering data. Data gathered from the FGD were analyzed using Braun and Clark’s (2006) thematic analysis, while the mean was used to determine the validity of the PTP. Findings reveal that the factors that affect the common adjustment issues of pre-kindergartners during the transition period are lack of social exposure, separation anxiety, time and routine adjustments, and excessive use of gadgets at home. On the other hand, the CDWs employ interactive learning activities, open communication, and parental involvement and support in handling adjustment issues during the transition period. Findings also reveal that the developed PTP is highly valid in terms of objectives (3.77), content (3.88), staff/persons involved (3.66), duration (4.00), and assessment/evaluative technique (3.78), along with the overall mean of 3.82. Thus, the PTP is recommended to be implemented to capacitate the CDWs in managing effectively the common adjustment issues of pre-kindergartners during the transition period.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0799/a.php" alt="Hit counter" /></p>

The impact of big fund on the operational efficiency of semiconductor companies: Corporate social responsibility as a non-economic output

This study contributes to research on the total factor operational efficiency of the semiconductor company considering corporate social responsibility (CSR) by proposing a novel integer-valued nonparametric frontier method. This method adopts an endogenous directional distance function, which first selects the benchmark and then endogenously determines the directional vector. Avoiding the issue of non-integer slack adjustment increases the convenience of formulating incentive plans and calculating efficiency. We apply this method to the input–output data of 185 listed Chinese semiconductor companies from 2010 to 2022, considering integer-valued CSR as non-economic output. Global Malmquist productivity index analysis shows that the average total factor operational efficiency of companies that received investment from the National Integrated Circuit Industry Investment Fund (Big Fund) increased by 6.9%. Using the econometric technique, we verify that the total factor operational efficiency of semiconductor companies receiving Big Fund investment increased by 0.084 compared to those without Big Fund investment. Heterogeneity analysis showed that the effect of Big Fund was more significant in improving the total factor operational efficiency of state-owned, new, and non-integrated circuit semiconductor companies, implying the necessity of purposeful investment policies for the Big Fund.

On Updating the Issues of Modernization and Adjustment of Mechanisms for Implementing Legal Policy in the Field of Ensuring National Security

On Updating the Issues of Modernization and Adjustment of Mechanisms for Implementing Legal Policy in the Field of Ensuring National Security

Does It Take a Village? The Impact of LGBTQ+ Community and Geographic Location on Associations among Parenting Stress, Parent Mental Health, and Child Adjustment.

While LGBTQ+-parented families share many similarities with their cis-het parent counterparts, they still experience unique factors exclusive to them. One such factor is access to the LGBTQ+ community. Utilizing a diverse sample of LGBTQ+ parents with adolescents in the U.S., primarily living in Southern and Midwest states, we examined the potential moderating impact of a parent's sense of LGBTQ+ community on the relationship between parenting stress, parent mental health, and child adjustment. Regression analyses demonstrated a series of positive associations between LGBTQ+ parent stress, parent mental health concerns, and child adjustment issues. However, sense of community failed to moderate these associations. Parent sexual identity, age, and recruitment method were found to have unique associations with outcome variables. Implications for policy, clinical practice, and future research are discussed.

Design and Preliminary experiment of an Off-axis aequilate-mirrors linear Fresnel concentrator with sunlight self-adaptive feature

The Off-Axis Linear Fresnel Reflector (LFR) is an innovative, compact solar concentrator designed to reduce device height and wind-load without compromising efficiency. It is crucial in applying LFR devices to applications such as building façades. To this aim, The Off-axis LFR design is introduced to addressing the inter-mirror blocking issue that diminishes the efficiency of conventional LFRs. Initially, an optimized Aequilate-mirrors design was proposed to reduce manufacturing complexity and cost. Subsequently, a crank-slider mechanism was introduced as a solution to the issue of inconsistent angle adjustment among the mirrors. Additionally, the paper details the sunlight self-adaptive feature of the Off-axis LFR concentrator, where the LFR mirrors can independently rotate to track the sun’s position, adaptively altering the mirror array’s profile and sunward aperture. This feature maximizes the device’s sunlight harvesting capacity, particularly in angled sunlight conditions. A prototype of the Off-axis LFR device was designed and built for assessment, featuring a focus length of just 78 mm and an overall 145 mm housing height. The paper then discusses how the sunlight self-adaptive features enhance the efficiency during the early morning and twilight hours. Comprehensive testing, including mechanical driving, laser focusing, and outdoor full-function verification, was conducted. Ultimately, comparative photo-thermal efficiency tests with a similarly sized conventional LFR concentrator demonstrated that the Off-axis LFR concentrator could achieve a significant increase in efficiency, with an all-day average thermal efficiency improvement of over 10 %. Based on the previous theoretical study, this study has completed the engineering prototype design and validation. And confirmed a thermal concentration efficiency of 44.36 % within a height of 145 mm in experiments.

Emotional Intelligence and Social Adjustment among Adolescents of Arunachal Pradesh

The capacity to keep track of one's own and other people's feelings and emotions, to recognise differences between them, and to utilise this knowledge to shape one's decisions and behaviour is known as Emotional Intelligence. One definition of adjustment is the process of changing behaviour to achieve harmony with the environment. A healthy connection with society is characterised by a proper awareness of social needs, requirements, and collective objectives as well as a commitment to satisfying the social demands of one's family, peers, culture, and community. Adolescents in our society are presently experiencing a variety of issues at various levels, and it has been determined that their personality disorders are closely related to the causes of these issues. The ultimate purpose of education, according to the current conception of it, is optimum adaptation. The teacher and guidance staff will be better equipped to give pupils with a quality education if knowledge on the adjustment issues of teenage students is available and their wants and feelings are taken into account and understood. The current study assesses the degree and connection between adolescents' Emotional Intelligence and Adjustment. Descriptive Research design has been used for the study. The method of gathering data employed is random sampling. The main conclusions of the current study are that Adolescents' Emotional Intelligence is high, although their degree of Social Adjustment is modest, and that there is a High Correlation between these two variables among the selected samples of Adolescents.

A Digital Twin-Based Adaptive Height Control for a Shearer

The shearer is an important component of the smart mining workface, and its effective control is a key aspect that guarantees safe and high-efficient production in coal mines. To address the issue of autonomous height adjustment during the shearer’s cutting process, a self-adaptive speed control method driven by digital twin technology is proposed. A digital twin-based control architecture for the shearer is first established, which consists of physical and the corresponding virtual entities, as well as reality–virtual interaction between them. Based on the mathematic model formulated for height adjustment system of the shearer, an adaptive fuzzy sliding mode controller (AFSMC) with the displacement estimation is designed for the virtual entity, with the purpose of guiding the operation of the corresponding physical entity. Simulation experiments on MATLAB compares the control performance among the proposed method and four comparative ones, including PID controller, integral sliding mode controller (ISMC), feedback linearization controller (FLC), and fuzzy sliding mode controller (FSMC). The experimental results confirm the effectiveness of the proposed AFSMC. More specifically, its steady-state error is 0.024, the maximum absolute control input is 8.43, and the settling time is 1.74 s. This also proves that the digital twin-based control method enables the precise adaptive height adjustment of the shearer, providing potential reference for the intelligent development of a smart mining workface.

India diaspora in Western Europe: adapting and negotiating identity

ABSTRACT Indian Diaspora is one of the largest Diasporas, spread over continents. The nature and composition of the Indian Diaspora in Europe are quite diverse in terms of its number, history, and contemporary dynamics, yet in a few aspects, there is a striking similarity. Besides the settled Diaspora, the countries in Western Europe have substantial numbers of migrants and some illegal migrants from India as well. The present article explores the patterns of adjustment and identity construction among the Indian Diaspora, particularly the second-generation, and how it is negotiating its connections with the host and home country. The article gives a brief historical description of the journey of the Indian Diaspora and settlement in a select few countries in Western Europe. Subsequently, it discusses the issues of identity, adjustment and sense of belonging, and finally, it focuses on the second-generation of the Diaspora and the process of negotiation of identity and adjustments.

Understanding the Adjustment Issues in Digital Humanities Among Female Academics in Advanced Career

It is no news that the world is a global village, the trend and advancement in digital content are not limited to the Sciences, Technology, Engineering and Mathematics (STEM), but have extended to the humanities as well. Digital humanities are a new pathway to modern research in humanities. Pedagogy in traditional humanities has changed in the last few decades. Academics are now compelled to teach, research and offer their services with the latest innovations. There are numerous challenges with catching up with the glimpse of digital technology in service delivery in all areas of research in current times. Dealing with large data seems impossible and time-wasting with the traditional Pedagogy of humanities. Female academics in advanced careers are facing more challenges in learning and using digital tools in their day–to–day activities, hence several of them are perceived or seen as inefficient/stagnated in advancing their careers. This study identified the adjustment issues particularly faced by female advanced career academics. The study used a mixed method approach to select ten (n=10) female academics with a mean age of 60 who were purposively selected for the study from the University of Lagos, Nigeria. The participants agreed that adjusting to digital humanities has been challenging and they highlighted the present state of their abilities in using digitals as instructional materials. The study concluded that the challenges confronting female academics are numerous, hence why catching up with the digital humanities and other related issues is responsible for the stagnation and less research output among female academics. The study recommended that there should be continuous training programmes for female academics in Nigeria. This study contributes to the growing literature on empowering women in academia. Keywords: Digital Humanities, Adjustment, Advance Career, Female Academics

Using Multi-dimensional Quorums for Optimal Resilience in Multi-resource Blockchains

Permissionless blockchains commonly use resource challenges to defend against sybil attacks. For example, popular resource challenge designs include Proof-of-Work and Proof-of-Stake. It is well-known that simultaneously exploiting multiple resources can help make a permissionless blockchain more robust. For example, combining PoW and PoS can help to keep a blockchain secure, even when the attacker controls more than 50% of the computational power in the system. While there have been existing efforts for combining multiple resources in blockchains, they only provide partial solutions. Specifically, it is currently still unclear how to combine PoW and PoS, or multiple resources in general, to achieve optimal resilience . Here by optimal resilience , we mean that the blockchain can tolerate every security region , unless that security region is proven to be impossible to tolerate. Existing designs are not able to achieve such optimal resilience. As our central contribution, this work proposes the novel design and formal security analysis of a blockchain protocol that combines PoS and PoW, which can be further generalized to multiple resources. Our blockchain is the very first blockchain that can achieve optimal resilience . Our design also overcomes a common tricky issue of PoW difficulty adjustment in previous designs. We have further implemented a research prototype of our blockchain design, and experimentally demonstrated its good end-to-end performance.

Experimental installation of a reference source of low currents for calibration of electrometers

Today, there is great scientific interest in the possibility of implementing reference sources of low currents based on single-electron pumps using the single-electron tunneling effect and the modern definition of the SI system. However, the practical use of this effect in everyday metrological practice has not yet reached the stage of widespread use. Typically, for routine calibration work in laboratories, either mass-produced instruments (low current sources and meters, electrometers) are used, which are calibrated against higher standards, or specially designed precision current sources. The article describes a reference installation developed on the basis of the VNIIFTRI, where in the mode of generating ultralow currents the principle of forming a linearly increasing voltage on a reference capacitor is used. A simplified block diagram of the reference setup is shown. Issues of practical adjustment of modern electrometers are considered. The generalized results of participation in international comparisons on low currents EURAMET.EM-S44 “Comparison of ultra-low DC current sources” conducted by national metrological institutes in 2018–2020 are presented. The results of a metrological study of the calibration factor Q and an example of calculating the uncertainty budget of measurements carried out at the VNIIFTRI as part of these international comparisons are presented. The research described in the article to increase the accuracy of measurements of small and ultra-low currents of this level has valuable practical significance in the field of electrical measurements, in aeroionometry and metrology of ionizing radiation.

"A different country, a different language, a different culture…" Educational experiences of international nursing students studying in Turkey: A qualitative study

AimThis study was aimed at investigating the educational experiences of international nursing students in Turkey. BackgroundNursing education has now gained an international dimension, which creates an environment where students from different cultures come together. In Turkey, nursing education is expanding internationally due to the increasing number of international students. DesignA descriptive- phenomenological qualitative study. MethodsThe study data were collected from nursing students who came to Turkey from 17 different countries between April 2023 and July 2023 to study at a nursing faculty in Turkey using a semi-structured interview form. Of these students, 27 constituted the study sample. The data collected were analyzed using the content analysis. The COREQ checklist was used in reporting the study. ResultsFour themes emerged: a) challenges, b) gains, c) support needs and d) recommendations. Among challenges reported by the participating students were language barriers, cultural adjustment issues and lack of social support. As for the gains of being a foreign student, they stated that they experienced intercultural interaction and improved their language skills, independence and self-confidence. In the study, the need for language support, provision of psychological assistance and cultural adaptation support for these students and the importance of practical recommendations such as mentoring programs and orientation trainings to improve their educational experience were emphasized. ConclusionIn conclusion, in this study, the importance of targeted strategies in nursing education in areas such as language support, psychological assistance and cultural adaptation was emphasized, which helps international students to have a successful educational experience. It was also concluded that mentoring programs and orientation trainings could enrich the educational processes of students by facilitating their adaptation to their new environment. This study is notable in the literature in that students from 17 diverse countries share the same program and the same prerequisites.

A model-free toolface control strategy for cross-well intelligent directional drilling

Toolface adjustment methods for directional drilling in oil and gas drilling currently rely heavily on manual real-time interventions for continuous adjustment. However, due to the influence of manual experience, these existing methods suffer from unstable effects and high labor costs. As energy consumption continues to rise, the demand for intelligent directional drilling is becoming increasingly pressing. To address the challenges posed by automatic adjustment issues encountered in actual drilling operations under various complex downhole environments, this study presents a model-free online learning adaptive decision strategy for cross-well intelligent adjustment and toolface stabilization, which is applicable for both slide and rotatory steerable systems. A reward function embedded with expert operating experience is developed to learn the orientation strategy from the driller's corrective actions. Additionally, a priority-based experience replay mechanism is introduced to enhance online learning efficiency. To accurately simulate the directional drilling process and pre-train the orientation strategy, a data-driven directional drilling simulation environment is proposed. With the aim of facilitating implementation and widespread adoption in practical engineering, this study also involves the migration of a strategic model, integration of a real-time interaction module, and encapsulation of algorithms for field applications. Simulations and field experiments are conducted to validate the effectiveness of the proposed strategy. The experimental results demonstrate that the strategy can achieve decision-making goals in a short period of time.

Social comparison and overall adjustment among freshmen in one public university

The freshmen in universities continue to face adjustment issues to new environments. Thus, transition to the university is characterized by expected independent decisions as compared to the previous secondary school teacher controlled learning environment.When the transition challenges are not well managed by the university administration, then it could lead to the emergence of psychopathology, as pre-existing mental health problems are exacerbated or new symptoms emerge in response to novel environmental stressors.The present study examined the relationship between social comparison and overall adjustment among the freshmen in one selected public university in Kenya. The study was informed by Social Comparison Theory (SCT) and Student Integration Theory.This study was anchored in the positivist research paradigm. The study was guided by the cross-sectional survey research design. The sample size comprised 213 freshmen in one public university in Western Kenya. The Social Comparison Scale and Adjustment Questionnaire were used to collect data. The validity results indicated that the Keiser-Meyer-Olkin (KMO) was 0.753. The Bartlett’s Test of Sphericity at 95% level of confidence was significant (p-value of .000 < 0.05). The finding shows that there was a low negative (r = -.142, n =213, p<.05) relationship between social comparison and overall adjustment among the first year university students. The study concludes that the social comparison regression model was adequate to predict overall adjustment among first year university students [F (1, 211) = 4.366, p< .05)].The study recommends that the university counseling center should develop holistic counseling therapies, which would enhance coping skills, seeking support, and counseling seeking behaviours among first year students

P23 Benchmarking voriconazole therapeutic drug monitoring in adults and paediatrics

Abstract Background Voriconazole is the first-line agent for invasive aspergillosis and microbiology approved fungal infections. Voriconazole acts as both a substrate/inhibitor of several hepatic cytochrome P450 enzymes and demonstrates non-linear kinetics due to metabolism saturation. Inter-individual variability of voriconazole pharmacokinetics is high.1 Therapeutic drug monitoring (TDM) of trough plasma levels can mitigate treatment failure/toxicity. A therapeutic index between 1 and 5.5 mg/L is aimed for.1 An online protocol directs IV/oral dosing in line with British National Formulary guidance. An audit was conducted to benchmark protocol compliance. Standards Total compliance to the following standards was investigated for all voriconazole prescriptions: (i) suitable indication; (ii) documented stop or review date; (iii) protocol prescribed loading and maintenance dose; (iv) dose adjustment for non-therapeutic voriconazole trough level; and (v) trough sampling between 4 and 7 days since initiation. Methods Retrospective voriconazole dispensing data (April 2020–April 2022) was used to identify treated adult and paediatric patients. Correlating electronic prescribing and medicines administration (ePMA) system data was examined in line with standards. Patients receiving voriconazole prophylaxis or under 7 days total treatment were excluded from data collection. Descriptive statistics were used to describe patient characteristics and compliance with standards. Results In total, 47 patients (31 adults and 16 children) were identified. The IQR of age was 48 years. Total compliance was obtained to standard (ii) only. Overall, 94% of patients’ prescriptions possessed an appropriate indication and 6% were clinically appropriate with unclear documented indications. A total of 66% received protocol directed loading and maintenance doses, 6% were prescribed appropriate loading doses, without maintenance doses, and 28% received an inappropriate loading/maintenance dose. Within 4 to 7 days since treatment initiation, 55% had therapeutic trough levels; 27% had supratherapeutic levels, but only 33% of doses were reduced, whereas when subtherapeutic trough levels were encountered in 18% of cases, 75% of doses were increased. Overall, 47% had plasma trough levels taken within the recommended period; 30% did not have a trough level ordered, whilst the remaining 23% had sampling taken before 4 days or after 7 days. Conclusions Person and system interventions are required to improve pre-/post-prescription standards. Prescriber education focusing on indication documentation and recent patient body weight for dosing is required. Whereas an ePMA prescribing package incorporating protocol guidance, consecutive loading and maintenance doses, plus trough sampling orders should be trialled. Protocol integrated instructions on dosing adjustment as done for other TDM drugs should be explored. Occasional nursing omissions of both 12-hourly loading doses on Day 1 of treatment should be addressed with practice educators. Reliance on an external laboratory and third party to communicate trough sample results was associated with delays. This should be investigated further as a cause of dose adjustment issues. ePMA availability of samples, direct laboratory communication with prescribers/pharmacists and investigations into cost-effectiveness of internal laboratory assays should be considered. Interventions should be agreed with stakeholders and reaudit occur. Earlier sampling and dosing practices better representing local the patient population could be investigated further as part of an antimicrobial stewardship improvement project.

The impact of artificial intelligence on the Go level examination

This article explores the application of artificial intelligence (AI) technology in Go level examinations and its impact on Go education and evaluation systems. With the advancement of science and technology, especially the rapid development of AI technology, Go, as an ancient strategic game, has experienced revolutionary changes in its competitive scenes and learning methods. After AlphaGo defeated world Go champion Lee Sedol in 2016, the application of AI in the field of Go received widespread attention. AI has not only demonstrated capabilities beyond humans in high-level Go games, but has also played an increasingly important role in Go teaching and training. The global spread of the COVID-19 epidemic has forced Go level examinations to find new ways to adapt. The Go online intelligent test came into being, providing a new, efficient and objective assessment method. Although the introduction of online intelligent examinations has brought convenience, it has also raised issues in organizational structure adjustment, revenue distribution, and examination fairness. Challenges faced by the Go online intelligence examination in terms of fairness, including lack of face-to-face supervision, possible cheating, etc., pose new challenges to the fairness and authority of the Go level examination. This article compares the differences between intelligent Go exams and traditional exams, including assessment format, exam content and passing rate. The online intelligent examination has added test questions and raised the requirements for candidates’ computing power. It also shows a higher passing rate than traditional methods. However, the authenticity and fairness of online intelligent examinations have been challenged, including the adaptability of AI game difficulty and the lack of examination supervision, leading to the emergence of cheating. The positive impacts of implementing online smart exams include improving the convenience and efficiency of exams, simplifying event organization, and promoting the development of Go players’ skills. But at the same time, this new form has had an impact on the original Go organizational structure and benefit distribution, causing concerns and adjustments from local associations. In order to solve these problems, this article puts forward a series of suggestions, including setting up a supervision mechanism for intelligent examinations, optimizing the assessment system, and adjusting the revenue distribution ratio to ensure the long-term sustainable development of online intelligent examinations. In summary, the use of artificial intelligence in Go level examinations not only reflects the persistence of the interaction between technology and traditional cultural activities, but also poses ongoing challenges to the fairness and validity of education and assessment methods. By deeply understanding these impacts and taking corresponding countermeasures, we can find a balance between innovation and tradition, and provide support for the development of Go education and evaluation systems.

Expatriate professional nurses’ experiences of preceptorship in a tertiary hospital in Saudi Arabia

Background: Professional nurses relocate to foreign countries as expatriate nurses due to host countries’ push or pull factors. Preceptorship programs are designed to support newly hired nurses in transitioning into a new health-care environment. Aims: This study aimed to understand expatriate professional nurses’ preceptorship experiences in a tertiary hospital in Riyadh, Saudi Arabia, with the goal of providing recommendations to enhance the preceptorship program and facilitate better adaptation among expatriate nurses. Setting and Design: This study was conducted at a tertiary military hospital in Riyadh, Saudi Arabia, and employed a phenomenological research approach. Materials and Methods: Based on inclusion criteria, ten expatriate professional nurses were selected by purposive sampling. Data were collected through unstructured, audio-recorded, verbatim transcribed interviews, observations, and field notes. Statistical Analysis: Colaizzi’s seven-step methodology was employed for data analysis. Results: The results identified three themes: (1) participants experienced both positive and negative aspects of preceptorship, encountering personal adjustment challenges and issues with the initial orientation program; (2) preceptors’ abilities and dedication played a crucial role in assisting participants in adjusting to their new workplace; and (3) participants reflected on their preceptorship experience, expressing their expectations and opinions of the preceptorship program. Conclusions: Preceptorship is an effective onboarding strategy to support expatriate nurses in their adaptation process, emphasizing the importance of teamwork and continued management support.

Academic Adjustment Issues in a Malaysian Research University: The Case of Cambodian, Laotian, Burmese, and Vietnamese Postgraduate Students' Experiences

Academic Adjustment Issues in a Malaysian Research University: The Case of Cambodian, Laotian, Burmese, and Vietnamese Postgraduate Students' Experiences

On the issue of adjustment and calculation of navigation depth parameters during route creating

The calculation of the values of navigation depths when planning the preliminary route has a strong influence even on the choice of one or another route, and changing weather conditions sometimes lead to its replacement with an alternative during the execution of the route, which adds to the risk of unexpected situations and the need to solve them in a short time frame. Also, determining the appropriate SENC settings for pre-laying, understanding the essence of the calculated safety parameters regarding navigation depths on ECDIS charts and the accepted values of ECDIS remain relevant due to the large number of involved ECDIS interfaces of different developers. The article deals with the issue of setting up SENC in relation to the previous layout, taking into account the use of various additional overlays: NavTex, AIO, weather maps. The necessity of using text signatures of vector objects, which were previously ignored due to blind trust in vectorization of maps, is shown. The article provides an in-depth interpretation of such vector objects as IDS, which do not change their own scale when changing the scale of the map. The given examples of erroneous interpretation of the Category Zone of Confidence showed the need for additional clarification of the essence of confidence zones and the specifics of using such errors when planning routes. Since the formulas for calculating the values of both UKC (under keel clearance) and Safety Contour have only recommended rules, the article provides information on the use of parameters in these formulas, as well as their interpretation by ECDIS software. The reasons and consequences of the lack of in-depth understanding of safety parameters regarding navigational depths for the route are shown. One of the variants of the Safety Contour and UKC calculation model is proposed, as well as the features of using the Safety Depth parameter. Specifics of using XTD and LDL are given

Effect of academic stress, educational environment on academic performance & quality of life of medical & dental students; gauging the understanding of health care professionals on factors affecting stress: A mixed method study.

Throughout their academic careers, medical and dental students face challenges that cause varying levels of stress, affecting their academic performance and quality of life (QoL). Our study aims to ascertain the effect of academic stress and the educational environment on the QoL and academic performance of medical and dental students, encompassing the perspectives of both students and healthcare professionals. A mixed-method research was conducted from February to May 2022, comprising students from a medical and dental college in Pakistan. During Phase 1, the students participated in the cross-sectional survey and completed the WHO Quality of Life Scale (WHOQOL-BREF), Academic Stress Scale, and Dundee Ready Educational Environment Measure (DREEM) Inventory questionnaires. Academic performance was evaluated through last year's annual assessment results of the students. During Phase 2 of the study, interviews with healthcare professionals who had experience as the students' counsellors were conducted. The mean age of the sample (n = 440) was 22.24 ±1.4 years. The Cronbach Alpha reliability of the DREEM inventory was 0.877, that of the Academic Stress Scale was 0.939 and the WHOQOL scale was 0.895. More than half of the students (n = 230, 52.3%) reported better QoL and the majority perceived a positive educational environment (n = 323, 73.4%) and higher academic stress (n = 225, 51.1%). Males had significantly more academic stress (p<0.05). Those who perceived a positive educational environment and better QoL had better academic performance (p<0.05). Academic performance was positively and significantly correlated with QoL and academic stress (p = 0.000). In qualitative analysis, 112 codes were generated which converged into 5 themes: challenging educational environment, psychological need and support, individual differences, relationship and family life, and adjustment issues. Medical and dental students encounter a myriad of challenges, along with significant academic stress, which detrimentally affects their academic performance, despite perceiving a positive educational environment. Conversely, a better QoL is associated with improved academic performance.