Final Questionnaire Research Articles

Utilising a STEAM-based Approach to Support Calculus Students’ Positive Attitudes Towards Mathematics and Enhance their Learning Outcomes

Abstract The curricular unit Calculus I – Extraordinary Semester (UCCISE) – was explicitly created to respond to students’ difficulties in the curriculum unit Calculus I (UCCI). Only students who fail the UCCI are allowed to attend UCCISE. Considering the enrolled students’ familiarity with mathematical software, the potential of group work to stimulate collaboration among students, and the existence of several art pieces on the University Campus, led to the proposal of a groups’ project focusing on the calculus of areas based on sections of these pieces. Hence, a STEAM approach emerged to achieve the suggested UCCISE objectives. This study aims to understand how using a STEAM approach in a higher education Calculus course could improve students’ perceptions of mathematics, promote their learning, and contribute to lower levels of failure in UCCISE, using teaching experiments as a research methodology. Four researchers were involved in this study, including the Calculus teacher, so this study has action research characteristics. The interpretive paradigm of analysis was used with the triangulation of data. The collected data come from the students’ productions, interviews, and final questionnaires. Results show that the work developed by the 35 students was relevant and should be a practice to be used in UCCI. This experience led to a reduction in the levels of failure compared to the UCCI. However, in the first years at a university level, STEAM approaches are still challenging.

DEVELOPMENT AND VALIDATION OF A QUESTIONNAIRE THAT SURVEYED DENTAL ASSISTANTS’ KNOWLEDGE, ATTITUDE AND PRACTICES OF INFECTION PREVENTION AND CONTROL MEASURES WITHIN SOUTH AFRICAN ORAL HEALTHCARE FACILITIES

Objective: In-depth research was conducted to find a suitable tool for measuring the knowledge, attitude, and practice of infection prevention and control (IPC) among dental assistants within oral healthcare facilities (OHCFs) in South Africa. However, the results were unsatisfactory, indicating the need to develop and validate a unique questionnaire for this purpose. This article explains the process followed to develop and validate a questionnaire designed to survey knowledge, attitude, and practices (KAP) in Health Sciences. Methods: To develop and validate a questionnaire, the researcher conducted a literature review to understand the process involved. The initial version of the questionnaire was then drafted. In order to assess its reliability and validity, both objective and subjective evaluations were conducted. A total of 25 individuals formed part of the respective review panels, including five academics, two infection prevention and control experts, five dentists, seven oral hygienists, and six dental assistants from public and private OHCFs. These individuals performed the subjective evaluations of the draft questionnaire. The draft questionnaire was then administered to a group of 60 dental students from the Central University of Technology (CUT). The data obtained from this group enabled the researcher to perform further objective evaluations by applying statistical measures using a Microsoft Excel programme. The reliability of items in the Knowledge domain was determined by the Kuder Richardson (KR20) test, with Cronbach’s alpha applied to items within the Attitude and Practice domains. A conservative approach to the interrater agreement (IRA) assessed the overall reliability. A panel of reviewers determined the face validity. Content validity was determined by the average congruency percentage (ACP), item content validity (I-CVI) and scale content validity (S-CVI). Results: The final questionnaire addressed seven IPC themes and encompassed 188 items. The tests to determine the instrument’s reliability yielded satisfactory results. The KR-20 score ranged between 0.94 and 0.65. The Cronbach’s alpha for items probing Attitude ranged between 0.99 and 0.86, and Cronbach’s alpha for items investigating IPC practices ranged between 0.97 and 0.69. The alternative approach to the IRA yielded 91%, and the conservative approach was 74%. Similarly, the tests to determine the validity of the questionnaire also yielded satisfactory results, with an ACP of 94%, above 90% I-CVI for readability, clarity, and feasibility and the S-CVI of 74%. Conclusion: The results of the reliability and validity tests confirmed that the questionnaire is suitable to measure the IPC knowledge, attitude, and practice of dental assistants.

MEASURING THE IMPACT OF THE CUSTOMER-BASED BRAND EQUITY (CBBE) DIMENSION ON BRAND LOYALTY: A STUDY ON SELECTED SMARTPHONES IN BANGLADESH

One of the most vital issues in brand building is Customer-based brand equity. Any brand can measure its brand equity grounded on some proportions like salience, performance, imagination, judgment, feelings, and resonance. This study aims to measure the effect of the customer-based brand equity dimension on brand loyalty and investigate the effects of those dimensions on their purchasing intentions. Both online and offline surveys were conducted through a self-structured questionnaire that was distributed randomly and conveniently among young consumers in Bangladesh, and data were collected from 220 respondents, whereas 200 completed final questionnaires were considered for the final study. All of the needed reliability and validity have been tested. Structured Equation Modeling (SEM) has been applied to examine the proposed hypothesis of the study with the help of SPSS (version 21). The results of this study show that, in the case of a few selected Smartphone categories, the salience, judgment, and feelings dimensions of customer-based brand equity have direct positive influences on enhancing customer loyalty, while performance and imagination have a negative impact. The study's findings will aid Smartphone marketers in developing effective marketing strategies to capitalize on market opportunities. This study was limited in sample size and geographically focused. End

The Difference in the Perception of the Performed Medical Treatment in a Public Institution and a Private Contractor – A Cross-Sectional Study – A Comparative Quantitative Analysis

Introduction: With our research we wanted to find out if differences exist, and if they do, what they are regarding the comprehension of treatment at the health service providers, who belong either to the purely public sector or to the private contractor (concessionaires). Methods: We prepared a pilot questionnaire, which was amended by using an Exploratory (EFA) and a Conformal Analysis (CFA) into a final questionnaire. We used the final questionnaire on 400 patients in an institution that belongs to the purely public sector and 400 patients at the concessionaire. Results: Thus, there were 800 patients involved in the research. In general, it bears mentioning that the evaluations given by these health services users were very high, regardless of their place of treatment. In all categories which we used for defining the comprehension of the health service, except for the comprehension of price, the answers at the concessionaire were statistically of more significant value. Conclusion: We can establish that, regardless of the provider, the general preception of healthcare services is very high. However, our study, which was limited by the number, as well as by the type of provider, confirmed that the patients who also visit the concessionaire gave us a significantly higher grade except in the price category. In our opinion, the methodology and the questionnaire are a good basis for similar studies in the future.

Environmental Sustainability and Urban Growth Issues: Empirical Evidence from Osogbo Capital Territory, Nigeria

Worldwide, urban centers have continued to see exceptional increase in spatial urban growth since more than 50 years ago in the majority of emerging countries. Osogbo, the capital of Osun State, is hardly discussed despite being one of the cities in Nigeria that is quickly urbanizing. In order to establish a justification for good governance in the pursuit of environmental sustainability, the article examines challenges related to urban growth and environmental sustainability in the Osogbo Capital Territory. Four Hundred and Fifty (450) questionnaires were distributed among the residents of six (6) residential areas and 384 questionnaires were retrieved, representing 85.33%, ergo judged fit for analysis of this study. Using a Stratified Random Sampling Techniques in order to ensure a fair representation of different socio-economic groups in Osogbo, Primary Data were obtained from field surveys with the administration of questionnaires across the Three (3) neighborhood strata to include: Core Area, Intermediate Area and New Areas. A pilot survey was conducted to test the reliability of the research instruments which paved the way for the refinement of the final questionnaire. The study used the severity index test of association, mean weighted score, and percentage-based descriptive methodology. The analysis's findings indicated that urban population growth had a big impact on environmental sustainability in terms of the state of the infrastructure and facilities, people's satisfaction with the facilities that are currently available, and the environmental issues in the neighborhood that was chosen. In order to maintain our cities and ensure the future well-being of inhabitants, the paper consequently advises proper methods of crucial policies to be held in order to achieve sustainable development, as this will further promote sustainability of Nigerian cities.

Iran osteoporosis registry: protocol for nationwide study.

Osteoporotic fractures can result in significant health complications and an increased risk of death. Registry studies could provide better treatment options and improve patient outcomes by providing useful information about the disease. The present study describes the protocol for an osteoporosis registry in Iran. This registry is a prospective multicenter cohort study recruiting patients with osteoporosis from Iran. The inclusion criteria of the study are individuals diagnosed with primary or secondary osteoporosis according to the diagnostic criteria of the study; patients will be identified and recruited from outpatient clinics in this registry. All patients diagnosed with primary or secondary osteoporosis are the target population of the study. Our expected sample size is 1000 participants and the study will continue for at least 2 years. The measurements of the Iranian Osteoporosis Registry include four parts: (i) variables measured by the specific questionnaires package, (ii) bone mineral density (BMD, (iii) clinical examination, and (iv) lab data. The final questionnaire package includes "demographics information", "socioeconomic status", "lifestyle", "reproductive health", "medical history and medication", "Osteoporosis diagnosis gap", "Osteoporosis adherence and treatment gap", "fracture history and fall risk assessment", "FRAX ® tool ", "hospitalization and death outcomes", "low back pain", "hospitalization history", "attitude toward osteoporosis", "osteoporosis awareness", "osteoporosis related-performance", "quality of life (Iranian version of SF12 questionnaire )", and "food frequency questionnaire (FFQ)". Clinical examination of this registry includes anthropometric measurements (including height, weight, body mass index (BMI), waist circumference, hip circumference, and right wrist circumference), and blood pressure. The baseline questionnaires will be filled out right after patients are diagnosed with osteoporosis and then osteoporotic patients will be followed up regularly on a yearly basis. In the follow-up visit, variables that may have changed over time are updated. The main outcomes include registration of fall, fracture, hospitalization, medication adherence, and death. An online web-based user-friendly software is also developed for data collection. Data analysis will be conducted with the collaboration of data-mining experts and epidemiologists at the end of each follow-up. The Iran Osteoporosis Registry will be a valuable source of information regarding osteoporosis outcomes (i.e. fractures, hospitalizations, adherence, and death at the national level), and its results will be very beneficial and practical for policy makers in the field of musculoskeletal diseases.

Pengaruh Model Teams Games Tournament (TGT) terhadap Motivasi Belajar Matematika Berdasarkan Gender Siswa Sekolah Dasar

The background of this research is that students are less motivated in learning and do not understand mathematical concepts. The problem in this research is limited to the lack of student motivation in the mathematics learning process and the Teams Games Tournament (TGT) type cooperative learning model is rarely applied in the mathematics learning process. The aim of this research is to determine the effect of the Teams Games Tournament (TGT) model on elementary school students' motivation to learn mathematics based on gender. The research method used in this research is quantitative methods. This type of research uses a quasi-experimental method (Quasy Experiment). The research was carried out at SDN 091482 Kasindir, Jorlang Hataran District, Simalungun Regency from September 4 to September 9 2023 in the odd semester of the 2023/2024 academic year. Based on the results of descriptive analysis data obtained from the students' learning motivation progress scores that were tested, in the male initial questionnaire, the average questionnaire score was 38.67, the standard deviation was 1,231, the maximum score was 41, and the minimum score was 36. Initial questionnaire women obtained an average score from the questionnaire results of 39.92, a standard deviation of 1,256, a max score of 43, and a minimum score of 38. Meanwhile, in the final questionnaire for men, the average score of the questionnaire results was 39.83, the standard deviation was 1,337, the The maximum value is 42, and the minimum value is 38. And in the final questionnaire for women, the average value of the questionnaire results was 40.54, the standard deviation was 1,330, the maximum value was 42, and the minimum value was 38. Based on the results of this research, the author put forward suggestions namely, 1). Students are expected to always be active and pay attention to the teacher's explanations during the learning process. 2). For all teachers, they must always innovate and be able to adapt to be able to use various learning methods so that students do not get bored easily in the learning process.

Abstract 17308: Patient and Primary Care Provider Experiences From an Implementation Study of a Risk Prediction Tool Integrating a Polygenic Risk Score and the QRISK2 Cardiovascular Risk Calculator

Introduction: We have previously shown that combining a polygenic risk score (PRS) for cardiovascular disease (CVD), with standard clinical risk calculators such as QRISK®2, results in improved CVD risk prediction via an integrated risk tool (CVD-IRT). Research Question: The objective of this study was to explore the implementation of CVD-IRT within routine practice in the UK National Health Service (NHS), through participant and healthcare provider (HCP) surveys and interviews. Methods: The Healthcare Evaluation of Absolute Risk Testing Study (HEART) (NCT05294419), a prospective, single-arm pragmatic trial, enrolled 836 participants undergoing health checks across 12 NHS general practices. QRISK2 and CVD-IRT scores were returned to participants via HCPs. The primary outcome of the study was feasibility of CVD-IRT implementation. This was assessed by a mixed methods approach (quantitative and qualitative methods). Results: After the results were reported and discussed, 520 surveys were completed by participants and 824 surveys were completed by HCPs. Subsequently, 21 participants were interviewed and 13 HCPs attended focus groups or interviews to explore their experiences. 23 HCPs completed a final questionnaire (34.8% physician, 21.7% research nurse, 43.5% other). For 90.7% of reports, HCPs indicated that the CVD-IRT could be incorporated into routine primary care in a straightforward manner. 80% of HCPs agreed that having these tests could lead to better health outcomes for patients, and 68.4% believed that the CVD-IRT could help them manage their patients through a shared decision making process covering lifestyle and treatment options. Participants found the report personally useful (98.5%) and easy to understand (94.3%); agreed that genetic measures are important to identify the risks of developing CVD (85.2%); thought that the test should be widely made available (interview summaries); and would recommend to friends and family (86.8%). Conclusion: The implementation of the CVD-IRT into routine health-checks was recommendable, feasible and well received by both HCPs and participants, who felt that the information was useful, could support clinical decisions, and easy to understand.

Abstract 13728: Generation of a Patient-Reported Outcome Measure of Quality of Life in Heart Valve Disease

Introduction: Heart valve disease (HVD) is common globally, yet there is no questionnaire measuring quality of life (QOL) across the lifespan of HVD. This limits assessment of changes in QOL in response to intervention in HVD. Research Question: What are all features of QOL in lived HVD, and how may these be best selected between to create a well-performing questionnaire? Goal: We aimed to generate a patient-reported outcome measure of QOL in common and significant types of HVD: aortic stenosis, mitral regurgitation, mitral valve disease in rheumatic heart disease, and valve repair/replacement. Methods: Participants were recruited from echocardiographic databases in two tertiary surgical centres in three phases. Phase One described QOL in interviews; Phase Two pilot-tested the questionnaire; and Phase Three selected between items using item distributions, exploratory factor analysis (EFA), and item response theory (IRT) to create the final questionnaire, called the Valve Quality of life (VALVQ). Results: In Phase One, 34 people with HVD, three family members, and five clinical experts were interviewed. Key features of QOL were physical capacity relative to ‘normal’, symptom interpretation causing reduced activity, and fatigue. In Phase Two, we showed in 62 participants that the resulting questionnaire - and its semantic differential item format - was functional. In Phase Three, 290 participants returned questionnaires. Items were removed for poor distributions, then EFA identified ‘physical capacity’ and ‘disease perception’ as key factors. A two-parameter Graded Response Model was used to generate the final 12-item VALVQ, which is shown in the attached table. Conclusion: Through application of sequential analyses across three phases, we generated the final 12-item VALVQ. It has two factors - physical capacity and disease perception - and can be deployed for future research on QOL in HVD, whether before or after intervention and across multiple forms of HVD.

Development and initial validation of the THL Adverse Childhood Experiences Questionnaire (ACE-THL)

BackgroundThe research on adverse childhood experiences (ACEs) has deepened our understanding of the long-lasting and cumulative effects of childhood adversities. However, the instruments measuring ACEs have several shortcomings, including limited item coverage, collapsing of items and response options, simplistic scoring, and inadequate psychometric assessments. ObjectiveTo design and conduct preliminarily psychometric testing for a brief new self-report instrument—the THL Adverse Childhood Experiences questionnaire (ACE-THL)—with a comprehensive set of clearly formulated items and appropriate response options. MethodsA previously published process model was applied to develop the ACE-THL questionnaire, which was validated by cognitive interviews (N = 20). Interviewers and interviewees completed the questionnaire separately for a cross-informant comparison. In a separate survey panel validation, the respondents filled out the ACE-THL twice, two weeks apart (N = 513, with 426 in the follow-up). Interview data were used to improve item clarity, and test–retest reliability and structural validity were assessed with repeated survey data. ResultsThe final 14-item questionnaire, including 12 ACE items and two items measuring protective experiences, was highly acceptable to the respondents. In the factor analysis of the quantitative data, a sufficiently single-dimensional construct was found, remaining stable in retesting two weeks later. The internal consistency (omega) of the a priori one-dimensional model was 0.89 and 0.90 at baseline and follow-up, respectively. The high test–retest reliability (mean score rank order correlation 0.93) of the ACE-THL indicated that the probed perceptions of childhood experiences are stable. ConclusionBased on the initial validation, the 14-item ACE-THL questionnaire is a reliable and valid instrument to measure adverse childhood experiences, as well as protective experiences.

Development of the cervical myelopathy severity index: a new patient reported outcome measure to quantify impairments and functional limitations

Background ContextExisting degenerative cervical myelopathy (DCM) severity scales have significant shortcomings, creating a strong impetus for the development of a practical measurement tool with sound psychometric properties. PurposeThis work reports the item generation and reduction of the Cervical Myelopathy Severity Index (CMSI), a new DCM patient-reported outcome measure of symptoms and functional limitations. DesignProspective observational study. Patient SampleAdult DCM patients belonging to one of three distinct treatment groups: (1) observation cohort, (2) preoperative surgical cohort, (3) 6 to 12 months postoperative cohort. Outcome MeasuresPatient-reported outcome measure of symptoms and functional limitations. MethodsItem generation was performed using semi-structured patient focus groups emphasizing symptoms experienced and functional limitations. Readability was assessed through think-aloud patient interviews. Item reduction involved surveys of DCM patients with a spectrum of disease severity and board-certified spine surgeons experienced in the treatment of DCM. A priori criteria for item removal included: patient median importance/severity <2 (of 4), 30% or more no severity (response of zero), item severity correlations ≤ 0.80 (Spearman), item severity reliability (weighted kappa <0.60) based on a 2-week interval and clinician median importance <2 with retention of items with very high clinical importance. ResultsThere were 42 items generated from a combination of specialist input and patient focus groups. Items captured sensorimotor symptoms and limitations related to upper and lower extremities as well as sphincter dysfunction. Ninety-eight patients (43, 30, 25 observation, pre- and postsurgery respectively) and 51 surgeons completed the assessment. Twenty-three items remained after application of median importance and severity thresholds and weighted kappa cutoffs. After elimination of highly correlated (>0.80) items and combining two similar items, the final CMSI questionnaire list included 14 items. ConclusionsThe CMSI is a new DCM patient-reported clinical measurement tool developed using patient and clinician input to inform item generation and reduction. Future work will evaluate the reliability, validity, and responsiveness of the CMSI in relation to existing myelopathy measurement indices.

Development and validation of a theory-based questionnaire examining barriers and facilitators to discontinuing long-term benzodiazepine receptor agonist use

BackgroundLong-term use of benzodiazepine receptor agonists (BZRAs) is a persistent healthcare challenge and poses patient safety risks. Interventions underpinned by behaviour change theory are needed to support discontinuation of long-term BZRA use. The aim of this study was to develop and validate a questionnaire based on the Theoretical Domains Framework (TDF) to examine mediators of behaviour change relating to the discontinuation of long-term BZRA use. MethodsAn initial 52 item questionnaire was developed using the 14 domains of TDF version 2 and iteratively refined over two rounds. The questionnaire was disseminated online via online support groups that focused on BZRAs to community-based adults with either current or previous experience of taking BZRAs on a long-term basis (≥3 months). Confirmatory factor analysis was undertaken to assess the questionnaire's reliability, discriminant validity and goodness of fit. The Standardized Root Mean Square Residual (SRMR), Root Mean Square Error of Approximation (RMSEA) and Comparative Fit Index (CFI) were calculated. ResultsFollowing an iterative process of adjustment, the results obtained from confirmatory factor analysis resulted in the final questionnaire consisting of 29 items across nine theoretical domains. The internal consistency reliability values across these domains ranged from 0.62 to 0.85. For the final model, the SRMR was 0.23, the RMSEA was 0.11 and the CFI was 0.6. ConclusionsThe questionnaire offers a potential tool that could be used to identify domains that need to be targeted as part of a behaviour change intervention at an individual patient level. Further research is needed to assess the questionnaire's acceptability and usability, and to develop a scoring system so that domains can be prioritised and subsequently targeted as part of an intervention.

Development and validation of primary health care quality assessment tool

BackgroundAssessing the quality of health services gives insights to managers about the status of services delivered by them, especially from the client’s perspective. Although various tools have been developed to measure the quality of primary health care (PHC), no specific tool was found in this field in Iran. Therefore, the present study was conducted to develop and validate the quality assessment tool of PHC in Iran.MethodsThis methodological study was conducted in 2021. In the first step, based on a literature review, an initial questionnaire was designed, and its face validity, content validity, construct validity, and reliability were evaluated. Descriptive tests, Kolmogorov-Smirnov, exploratory factor analysis, Kaiser-Myer-Olkin (KMO), and Cronbach’s alpha were performed by using SPSS 22.ResultsThe initial questionnaire included 33 items, of which three items were removed due to inconsistency with factorization. The final questionnaire consisted of 30 items and nine dimensions: interaction, efficiency, timeliness, accuracy, consultation, tangibility, safety, accessibility, and environment. The KMO and Cronbach’s alpha index values were 0.734 and 0.82, respectively, indicating acceptable reliability and validity. The developed dimensions represented about 73% of the total variance.ConclusionThe designed questionnaire has relatively good validity and reliability and can be used to measure the quality of PHC and to identify weaknesses in service delivery. However, researchers should carefully examine it to enhance its applicability as a standard tool for measuring PHC quality.

Assessing knowledge, attitude, practices and vaccine hesitancy in nurses: a pilot study

Abstract Background The use of a validated and reliable tool to assess knowledge, attitude, practices (KAP) and vaccine hesitancy (VH) in nurses is critical to developing tailored public health strategies to implement adherence to recommended vaccines for healthcare workers (HCWs) and reduce the chance of spreading vaccine-preventable diseases. The aim of this study is to develop and validate a tool to assess nurses’ vaccine hesitancy and KAP regarding recommended vaccines for HCWs. Methods Following a systematic review of the literature (PROSPERO ID:CRD42020212252), a new tool was built to assess vaccine hesitancy using the framework of the WHO Strategic Expert Advisory Group on Immunization. The pilot study collected responses from a random sample of nurses and nursing students. The content validity (including face-validity) was evaluated with a panel of experts. Internal reliability was tested using Cronbach's alpha (α). Results The final questionnaire consisted of three sections and forty items. A total of 124 individuals, 40 nurses and 84 nursing students were enrolled. Regarding KAP: only ten nurses (26.3%) reported adequate knowledge of recommended vaccines for HCWs, while no students reported knowing the vaccines included in the recommendations. 40% of nurses and 63% of nursing students discuss safety and efficacy of vaccinations during clinical practice. Twelve (32%) nurses and 42 (50%) students reported VH for at least one of the recommended vaccines for HCWs, with particular regard to flu vaccination and COVID-19 vaccine for which, despite being vaccinated, half of nurses and students reported concerns mainly about efficacy and safety. The reliability of vaccine hesitancy scales in nurses (α = 0.82) and nursing students (α = 0.85) could be considered good. Conclusions Following the validation of this tool, a multicenter cross-sectional study will be conducted involving three universities (Sapienza, Bicocca, Turin) on a national sample of nurses and nursing students. Key messages • Systematically measuring vaccine hesitancy in at-risk populations with a nationally validated tool enables implementation of targeted public health strategies. • Identifying nurses’ knowledge, attitudes, and practices regarding vaccination and vaccine hesitancy enables organizations to adequately address the training needs of their health workers.

DEVELOPMENT OF LEARNING MODULES WITH DATA PRESENTATION MATERIALS TO INCREASE STUDENTS' INTEREST IN LEARNING

The aim of the research is to develop a data presentation module to increase students' interest in learning. This type of research is research and development (R&amp;D), with the ADDIE model. Qualitative and quantitative data analysis techniques. Validation results of the material section 4.26 valid category. The validation of media experts is 4.50 valid categories and the validation of linguists is 4.87 categories which are very valid. Practical results in confined classes and fields. The results of practicality in the limited trial using a student response questionnaire and a questionnaire of initial and final student learning interest, the results of the practicality percentage obtained a maximum value of 2.72 in the very practical category, the practicality test using a final learning interest questionnaire with a value of 4.9 in the very practical category. The practicality result in the field trial was 4.72 in the very practical category. The results of the effectiveness of the test module obtained an average score of 75 in the complete category. Hopefully the results obtained above can make further researchers easier to understand so as to increase student learning interest

Hyperacusis Assessment Questionnaire-A New Tool Assessing Hyperacusis in Subjects with Tinnitus.

Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. The aim of the study was to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and to evaluate its psychometric properties. The study sample consisted of 106 adult patients with hyperacusis and tinnitus with a mean age of 45.2 years. A medical interview, an audiological examination, and several questionnaires (the Tinnitus Handicap Inventory, the Hyperacusis Questionnaire, the State-Trait Anxiety Inventory, and Visual Analog Scales) were applied. The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure with 70.5% of the variance explained. Convergent and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. The internal consistency assessed with Cronbach's alpha was excellent (α = 0.91), as was reproducibility (intraclass correlation, ICC = 0.96). The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool assessing the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus.

The New Zealand eating behavior questionnaire – Validation study for a novel assessment tool to describe actionable eating behavior traits

Individualised management of obesity remains challenging and, to date, most treatment is based on clinical judgement. This study aimed to develop and validate a novel questionnaire-based tool to identify three pre-defined eating behavior (EB) traits, emotional eating, reduced satiety (constant hunger) and reduced satiation (feasters) that may predict selective medication response given their targeted actions. We recruited 977 individuals from a tertiary academic diabetes clinic to participate in this two-phase validation study. Participants self-reported weight management activities and were asked to self-assess their EB characteristics. The initial questionnaire included 42 visual analogue scale questions. In Phase I, 729 participants completed the questionnaire, including Māori (11.8%) and Pacific peoples (19.3%). After random division of the study sample, Exploratory Factor Analysis (EFA) confirmed a three-factor model as the best fit. Stepwise removal of items with inadequate factor loading retained 27 of 42 items, which accounted for 96% of the variance. Confirmatory Factor Analysis (CFA), performed on the second half of the sample, demonstrated good model fit with the final 27-item questionnaire. Internal consistency was high for factor (α = 0.82–0.95) and demographic subgroups, and similar to those obtained in the EFA. Test-retest reliability in a subset of 399 participants who repeated the questionnaire after a four-week interval (Phase II) showed moderate to good reliability. Participants classified into one of three EB types based on the highest median score among the factors. Test-retest reliability was robust for emotional eaters (71.25%) and constant hunger (68.9%). The correlation between aggregate EB score (sum of three EB scores) and BMI was significant (Spearman rho = 0.314, P = .0005). The questionnaire reliably identified three distinct EB traits, which may be informative for precision medicine applications for obesity management.

Significant Factors Causing Delay of Ethiopian Road Construction Projects performing by Foreign General Contactors

Following the booming of the Ethiopian construction industry, a number of Foreign General Contractors (FGCs) are participating in the industry. The severity of the construction projects schedule delay, which is a worldwide problem also, affecting the FGCs participating in the Ethiopian road construction projects. Identifying the challenging factors affect the project performance was an important and initial stage for improving the project progress. This study identified the significant factors that cause the projects schedule delay systematically and objectively. After 30 factors were determined from literature and pilot survey, the final questionnaire survey of 235 domain experts was conducted to systematically select 20 factors. Based on the 20 selected factors, 81 historical data of road construction projects with schedule delay were collected; and the database was established. The artificial neural network (ANN) inference model was developed to train the database and predict the project schedule delay. Integrating it with the Garson algorithm (GA), the relative weights of challenging factors with rankings were calculated and identified. The top ten significant factors identified were Contractor's poor site management; Ineffective planning, scheduling, controlling and quality monitoring; Difficulty in Budget availability for the project; Delays in construction activities due to weather changes; late land acquisition; Shortage of materials; Financial problem of contractors; Poor supervision; Cash-flow problems (irregular payments), and Financial Capability of Client. This study uses as a significant reference for FGCs who are currently working in the Ethiopian Road construction projects for improving the projects schedule performance.

Development and Psychometric Evaluation of the Safety Evaluation Tool in the Laboratories of the University Complexes

Introduction: Laboratories play a crucial role in education and scientific research by providing an environment for various experiments and investigations. However, due to potential hazards such as chemical, biological, and physical agents, laboratories are inherently considered dangerous work environments. Therefore, it is essential to have a reliable and valid tool to evaluate the safety of these environments comprehensively. Therefore, this study was conducted to design and psychometrical evaluation a comprehensive tool for safety evaluation in university laboratory complexes. &#x0D; Materials and Methods: In the first stage, a Checklist was developed across various areas through a process that involved using a literature review, field visits, Interviews with laboratory technicians, and creating videos from multiple laboratories. The initially designed questionnaire was sent to 10 safety experts for face validity, and then their comments on the question phrasing were considered. To assess the content validity, two measures were employed: the Content Validity Ratio (CVR) and the Content Validity Index (CVI). Additionally, the reliability of the instrument was evaluated using Cronbach's alpha calculation method.&#x0D; Results: In the initial stage, a total of 286 questions were designed within 9 different areas. Subsequently, 49 questions were removed by expert members due to overlapping concepts, resulting in a final questionnaire consisting of 237 questions. The content validity index and relative coefficient were found to be above 0.8 in all areas, indicating strong content validity. Furthermore, Cronbach's alpha value exceeded 0.7 in all areas, suggesting a desirable level of reliability for the designed program.&#x0D; Conclusion: The results of this study demonstrate that the developed questionnaire exhibits acceptable levels of validity and reliability. As such, it can serve as a comprehensive and suitable tool for monitoring safety in University complex laboratories.

The perceived impact of curricular and non-curricular factors on specialty interests and choice during medical school at a single center in the United States

BackgroundLimited information exists regarding how medical students’ specialty interests evolve throughout medical school, particularly interest in surgical versus non-surgical specialties. Our objective was to identify medical students’ specialty interests before and after medical school and the most important curricular and non-curricular factors that shaped their specialty choice.MethodsAn online 22-question voluntary, anonymized survey was designed to assess specialty interests and factors impacting specialty choice at a single medical school in the United States. The study was pilot-tested with focus groups. The final questionnaire was distributed to final-year medical students from the Classes of 2020 and 2021. Responses were measured on a 5-point Likert scale (1 = strong negative impact to 5 = strong positive impact).Results102 of 184 students (55%) from Class of 2020 and 85 of 174 students (49%) from Class of 2021 participated. Of 187 respondents, the majority (60%) decided on their specialty during third year. 74 of 147 students (50%) pursued a specialty among their initial specialty interests. Students with initial surgical interests were significantly (p < 0.001) less likely to choose surgical specialties (42%) compared to students with initial non-surgical interests choosing non-surgical specialties (79%). Pre-clinical years (3.67 ± 0.96) were perceived to have a significantly (p < 0.001) less positive impact on specialty interests and choice compared to clinical years. Among pre-clinical factors, physician shadowing (3.80 ± 0.83) was perceived to have the significantly (p < 0.001) greatest positive impact. During clinicals, 34% of respondents indicated that order of clerkships impacted specialty choice. 112 of 171 respondents (65%) indicated that mentorship impacted specialty choice. Physicians in the chosen specialty were perceived to have the strongest impact (4.67 ± 0.49). 65 of 171 respondents (38%) indicated that peers impacted specialty choice with classmates (3.98 ± 0.87) and near-peers (3.83 ± 0.74) perceived to have a positive impact.ConclusionsSpecialty interests changed during medical school for a significant portion of students (50%). Those with initial surgical interests were more likely to change their specialty interests. Pre-clinicals were reported to have less impact on specialty choice compared to clinicals. Implementing factors such as shadowing and physician/peer mentorship, which may positively impact specialty choice, into pre-clinical curricula warrants further investigation.