High-level Indicators Research Articles

COVID-19 and coworker conflict among emergency medical service clinicians.

Safety policies enacted in response to the emergence of coronavirus disease 2019 (COVID-19) have greatly affected the working environments of emergency medical service (EMS) clinicians. Our objective was to evaluate whether changes in the EMS environment during the COVID-19 pandemic were associated with increased workplace conflict. This evaluation was a cross-sectional analysis of a random sample of 19,497 national certified EMS clinicians who were selected to receive an electronic survey in April 2022. The survey included an assessment of their level of stress using the Perceived Stress Scale instrument and examined changes in their working environment they perceived had occurred due to the emergence of COVID-19. Logistic regression modeling was used to evaluate the associations between workforce demographics, infrastructure, scheduling, and policies to and COVID-19-induced coworker conflict. A total of 1686 responses were evaluated (response rate 10%). We found that COVID-19 was reported to have exacerbated conflict between coworkers in 51% of responses. Respondents who perceived an increase in coworker conflict due to COVID-19 self-reported higher levels of stress than the rest of the respondents. Perceptions of the impact of COVID-19 on conflict had also an association with the level of certification, indicating that national registered paramedics were more likely than emergency medical technicians to report coworker conflict due to COVID-19 (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.05-1.61). Multivariable analysis highlighted the impact of mandatory overtime policies, reported by 27% of the respondents and associated with higher odds of exacerbated coworker conflict in our model (AOR 2.05, 95% CI 1.62-2.60). These findings indicate that conflict can be considered a potential indicator of high levels of stress in the EMS workforce and may be a reliable signal to monitor when implementing mandates that affect EMS clinicians and their workloads.

The effect of independent activities in healthy fitness on the psycho-emotional state of female students of vocational schools in the conditions of marital state

The full-scale war on the territory of our country affected all Ukrainians without exception, including student youth. Therefore, the relevance of studying the problems of the psycho-emotional state of the individual in today's conditions is extremely important. The purpose of the study was to analyze the influence of self-remedial fitness classes on the psycho-emotional state of female students of higher education institutions under martial law. Research methods: theoretical analysis, testing, pedagogical experiment, methods of mathematical analysis and statistics. The article presents the developed methodology of self-improvement fitness classes, which is conventionally divided into three stages. The test results obtained at the end of the study indicate that the psycho-emotional state of female students improved after the implementation of the method of self-remedial fitness classes, in relation to each indicator, namely: the increase in the indicator of low level of anxiety improved by 4.1%, medium and high level of anxiety, respectively, by 2% each . For low and high levels of frustration, in percentage terms, the scores improved by 2% each, and the average scores improved by 5%, respectively. The indicators of low and high levels of aggressiveness respectively improved by a percentage of 2% each, and indicators of medium level of aggressiveness respectively improved by 5%. Regarding the average level of rigidity, the indicators in percentage ratio improved by 1%, respectively, low and high level of rigidity in percentage ratio by 3% each, which ensured the achievement of the set goal. Further scientific research can take place in the area of determining the impact of independent health fitness classes on the level of physical fitness of female students of higher education institutions under martial law.

A reciprocal relationship between mitochondria and lipid peroxidation determines the chondrocyte intracellular redox environment

In orthopedic research, many studies have applied vitamin E as a protective antioxidant or used tert-butyl hydroperoxide to induce oxidative injury to chondrocytes. These studies often support the hypothesis that joint pathology causes oxidative stress and increased lipid peroxidation that might be prevented with lipid antioxidants to improve cell survival or function and joint health; however, lipid antioxidant supplementation was ineffective against osteoarthritis in clinical trials and animal data have been equivocal. Moreover, increased circulating vitamin E is associated with increased rates of osteoarthritis. This disconnect between benchtop and clinical results led us to hypothesize that oxidative stress-driven paradigms of chondrocyte redox function do not capture the metabolic and physiologic effects of lipid antioxidants and prooxidants on articular chondrocytes. We used ex vivo and in vivo cartilage models to investigate the effect of lipid antioxidants on healthy, primary, articular chondrocytes and applied immuno-spin trapping techniques to provide a broad indicator of high levels of oxidative stress independent of specific reactive oxygen species. Key findings demonstrate lipid antioxidants were pro-mitochondrial while lipid prooxidants decreased mitochondrial measures. In the absence of injury, radical formation was increased by lipid antioxidants; however, in the presence of injury, radical formation was decreased. In unstressed conditions, this relationship between chondrocyte mitochondria and redox regulation was reproduced in vivo with overexpression of glutathione peroxidase 4. In mice aged 18 months or more, overexpression of glutathione peroxidase 4 significantly decreased the presence of pro-mitochondrial peroxisome proliferation activated receptor gamma and deranged the relationship between mitochondria and the redox environment. This complex interaction suggests strategies targeting articular cartilage may benefit from adopting more nuanced paradigms of articular chondrocyte redox metabolism.

Physical Activity, Fitness, and Long-Term Risk of Amyotrophic Lateral Sclerosis: A Prospective Cohort Study.

Observational studies have demonstrated an increased amyotrophic lateral sclerosis (ALS) risk among professional athletes in various sports. For moderately increased levels of physical activity and fitness, the results are diverging. Through a cohort study, we aimed to assess the relationship between indicators of physical activity and fitness (self-reported physical activity and resting heart rate) and long-term ALS risk. From a large Norwegian cardiovascular health survey (1985-1999), we collected information on self-reported physical activity in leisure time, resting heart rate, and other cardiovascular risk factors. Patients with ALS were identified through health registries covering the whole population. We fitted Cox proportional hazard models to assess the risk of ALS according to levels of self-reported physical activity in 3 categories (1: sedentary; 2: minimum 4 hours per week of walking or cycling; 3: minimum 4 hours per week of recreational sports or hard training), and resting heart rate modeled both on the continuous scale and as quartiles of distribution. Out of 373,696 study participants (mean 40.9 [SD 1.1] years at inclusion), 504 (41.2% women) developed ALS during a mean follow-up time of 27.2 (SD 5.0) years. Compared with participants with the lowest level of physical activity, the hazard ratio was 0.71 (95% CI 0.53-0.95) for those with the highest level. There were no clear associations between resting heart rate and ALS in the total sample. In men, the hazard ratio of ALS was 0.71 (95% CI 0.53-0.95) for those reporting moderate levels of physical activity and 0.59 (95% CI 0.42-0.84) for those reporting high levels, compared with those reporting low levels. Men with resting heart rate in the lowest quartile had 32% reduced risk of ALS (hazard ratio 0.68, 95% CI 0.49-0.94) compared with those in the second highest quartile. In women, no association was detected between neither self-reported levels of physical activity nor resting heart rate and ALS risk. Indicators of high levels of physical activity and fitness are associated with a reduced risk of ALS more than 30 years later in men, but not in women.

Time estimation is associated with the levels of distress in patients prior to starting radiotherapy

Purpose or ObjectiveThe aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy. Materials and MethodsIn this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress. ResultsThe time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75– 0.85, p < 0.001) and with a sensitivity of 77.8 % and specificity of 73.3 %. In a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress (OR 0.136; 95 % CI, 0.072–––0.256, p < 0.001). ConclusionTime estimation is a novel potent indicator of high levels of distress in cancer patients prior starting of radiotherapy.

An investigation of the interrelationship among circular supply chain management indicators in small and medium enterprises

Circular Supply Chain Management (CSCM) is gaining prominence among diverse stakeholders, practitioners, and scholars. However, its adoption remains limited, particularly within Small and Medium Enterprises (SMEs). This study employs Interpretative Structural Modeling (ISM), specifically tailored for SMEs, to elucidate the contextual relationships among CSCM indicators. Furthermore, it employs the Matrice d’Impacts Croisés Multiplication Appliqué à un Classement (MICMAC) analysis to categorize these indicators into driving- dependence power quadrants. Thirteen CSCM indicators are identified and classified into three sustainability dimensions: economic, environmental, and social. The ISM model comprises four levels, with employees’ exposure to hazardous materials at level one, followed by ten indicators at level two, one at level three (reuse, remanufacturing, recycling complexity), and one at level four (eco-material). MICMAC analysis reveals that none of the indicators falls into the autonomous quadrant. Employees’ exposure to hazardous materials is categorized in the dependent indicators’ quadrant, while ten indicators belong to the linkage quadrant. The independent quadrant includes two indicators: eco-material and reuse, remanufacturing, and recycling complexity. SMEs can utilize these CSCM indicators as an initial step toward circularity implementation. The recommended implementation sequence follows the ISM model hierarchy, starting with level four indicators and progressing through levels three, two, and one, acknowledging the influence of higher-level indicators on lower-level ones.

The effectiveness of using simulation in learning a foreign language

The aim of this study was to measure how the use of simulation contributes to the improvement of speaking skills and the enhancement of students' motivation to learn a foreign language. The methods of observation, testing, and expert evaluation were used to diagnose the criteria of foreign language communicative competence (motivational, cognitive, and behavioral). The quality of the manifestation of interaction was correlated with its development, and three levels of foreign language communicative competence among students were distinguished: low (reproductive), medium (reproductive-productive), and high (productive). The study results showed that the EG significantly increased the indicators for all foreign language communicative competence criteria. The comparison of the results of the two experimental stages revealed a higher increase in indicators of high and medium levels of foreign language communicative competence in the second stage (high level—by 10.1%, medium level—by 4.9%). It was determined that simulations contribute to the gradual development of all foreign language communicative competence criteria. The main advantages of simulations are that they provide an opportunity to reproduce various communicative situations, thereby contributing to improving speaking skills, understanding the language in real time, and adapting to the requirements of real communication. The prospect for further research is the study of the impact of different forms of simulation on the effectiveness of foreign language learning.

ADAPTATION COMPONENT AS A CONSTITUENT OF FOREIGN STUDENTS SUCCESSFUL TRAINING IN MEDICAL UNIVERSITIES OF UKRAINE

Abstract. The article highlights the main tasks of higher medical education in Ukraine. It is noted that one of the global tasks of higher medical education development in Ukraine is the qualitative training of foreign students. The successful process of their education is a kind of indicator of high level of education in Ukraine, a confirmation of its international scientific, educational and cultural authority. It is indicated that attraction of foreign students to Ukrainian medical institutions of higher education performs not only economic functions, replenishing the country's budget at the expense of students studying on a contract form of education, but also stimulates cultural exchange between countries, affects the formation of future medical elite. Foreign students who remain in our country after graduating from Ukrainian higher education institutions have particular interest for the research. During their studies, they not only receive education, but also master the Ukrainian language, adapt to economic, cultural and other living conditions. Such graduates are very valuable for the future of our country. In connection with this, the question of adaptation of foreign students to living and studying in Ukraine is being brought up to date as the quality of education and professional socialization of foreigners depends on its success.&#x0D; The adaptation component plays an important role in studying process of foreign students. Students encounter adaptation difficulties from the first days of their studies. Foreigners find themselves in an unfamiliar cultural, linguistic, household and social environment, which they need to master, so the educational process is accompanied by adaptation to new living conditions. An important role in the process of foreign students’ adaptation in the universities of Ukraine has the organization of the educational process itself and the direct participation of the teacher in it. However, the successful implementation of the adaptation component is facilitated not only by classroom work, but also by extracurricular work, as it is an integral part of educational and educational processes.&#x0D; An important role in the process of adaptation of foreign students in universities of Ukraine is played by the organization of the educational process itself and the direct participation of the teacher in it. However, the successful implementation of the adaptation component is facilitated not only by classroom work, but also by extracurricular work as it is an integral part of the educational and pedagogical processes.

Morphological, pathogenic and genetic diversity in Diplodia seriata associated with black rot canker of apple in India

Apple cankers are extremely destructive diseases threatening the global apple industry through direct and indirect losses. The population structure of the pathogens is of paramount significance for the development of efficient management strategies. Therefore, phenotypic, pathogenic, and genetic diversity of Diplodia seriata causing black rot canker of apple was investigated in this study. All the isolates were included for investigating the in vitro mycelial growth, conidial dimensions, and pathogenic variability on two-year-old potted apple seedlings. The ISSR approach was used to investigate the molecular diversity of D. seriata. Mycelial growth rates were found to vary significantly amongst the isolates; however, there were no major variations seen between the different geographical groupings of isolates. Pathogenicity tests revealed variations in the size of cankers among the isolates indicating the presence of virulence variability. The isolates were segregated into three virulence groups based on canker length. The Bayesian analyses of ISSR data divided the isolates into two genetic clusters. The genetic clustering of the isolates revealed no relationship with geographical origin of the isolates. Furthermore, no direct relationship of genetic clustering was observed with morphological or pathogenic variability. The ISSR primers revealed very high level of variability in D. seriata; however, no distinct populations of the pathogen existed which is an indication of high level of gene flow between the diverse geographical populations. According to our knowledge, this is the first thorough investigation on the diversity of D. seriata associated with apple black rot canker in India.

Trajectories, comorbidity, and risk factors for adolescent disordered eating and borderline personality disorder features.

Borderline personality disorder (BPD) and eating disorders are highly comorbid, but the shared course of symptoms and associated risks remain poorly understood. The aim of this study was to examine joint symptom trajectories, temporal precedence, risk factors, and population attributable fractions (PAFs) in a community sample of adolescents, using a developmental psychopathology and psychosocial framework. Across five years (age 14-18 years), adolescents (n = 544, 56% girls) reported on BPD features and disordered eating behavior. Sociodemographic, interpersonal, and clinical risks were assessed in childhood (age 10-13 years). We used a person-centered approach to examine latent class growth analyses, joint trajectory models, and calculated PAFs. Three-class solutions were found for both disordered eating and BPD features (low, moderate, high), creating nine joint trajectories. High levels of disordered eating were a stronger indicator of high levels of BPD features than was the reverse. Girls and LGBTQ+ youth were most likely to be in a high symptom trajectory. Bullying perpetration and clinical hyperactivity were unique risks for BPD features. Bullying victimization contributed the largest PAF to disordered eating and BPD features. We identified several novel and clinically relevant findings related to temporality, risks, screening, and the treatment of adolescent eating problems and BPD.

MARUNDA AIR QUALITY INDEX BASED ON CONTENT OF PM 2.5 AND PM 10 ACCORDING TO THE CRITERIA DETERMINED BY ENVIRONMENTAL PROTECTION AGENCY OF UNITED STATE OF AMERICA

Marunda is an area located in North Jakarta, several Industrial and warehousing located in this area, as well as special port such as: Millitary port, coal and sand loading and unloading. As a Industrial and warehousing area, tranportation marunda dominated by Container Truck and heavy Equipment. Main source of energy for industrial area came from coal and petroleum, and main source of energy for transportation activity came from petroleum, this is the main cause of air pollution in Marunda. Indication of high levels of air pollution can be seen by amount of dust (fine particles) that scattered on the floor. Based on existing studies has been known that air pollution has negative impact for human health. In this articles will be discussed level of air pollution in marunda based on the content of particulate matter 2.5, particulate matter 10 and Nitrogen Dioxide in the air.

Analysis of injectable drugs (Pentazocine and Diazepam) sampled from shops and companies in Anambra State, Nigeria

The incidences of drug adulteration and drug resistance have been a major problem facing mankind in recent years. Low and medium-income countries like Nigeria are most affected. An investigation was carried out to determine the quality of Pentazocine and Diazepam injections in circulation in Anambra State. The injections were sampled from different markets, shops, and pharmaceutical companies within the State. Imported and locally manufactured brands of the injections were analysed. Identification, pH, Assays, Bacteria Endotoxin, sterility, and sub-visible particulate matter contamination were analysed. The results of the Identification, Bacteria Endotoxin (BET), Particulate matter count, and pH are all within the British Pharmacopeia. The Pentazocine Assays obtained were (98.31%- 102.5%) which are within the British Pharmacopeia limit of (95% – 105%). This is good for health management. The Assays of two of the Diazepam injections tested were between (111.33% - 111.53%), which is above the approved British Pharmacopeia limit of (90%-110%). This is an indication of high level of impurities and not good for health care management.

EVALUATION OF NOISE ON RING SPINNING MACHINES

The ring spinning system is a system that continuously spins yarn and winds bobbins. This yarn, after leaving the delivery rollers, takes the twist of the rotating spindle and traveler, and is wound onto the bobbin, which goes as overlapping on the spindle. The degree of weight in the spinning mills increases. On top of that, one of the reasons is working at its higher speeds to improve the production rates in the production process in a competitive environment of development. The evaluation and evaluation of speed balance almost as a whole is increasing, and in the evaluation of more energy in sound. assessment does not qualify as a problem of poor human health and condition in many countries. It is at a level to serve people. “Production rather than production consists of elements freed from the emergence of high-level indicators. Fuzzy logic can be developed by tool from tool pilots with predictive and general applicability to the planning of aircraft by human being difficult to craft. In this model, the appropriate gear wheel on the appropriate type gear wheels.

Potential Role of Ribonucleotide Reductase Enzyme in Mitochondria Function and Woody Breast Condition in Broiler Chickens.

The cellular events leading to the development of the woody breast myopathy in broiler breast muscle are unclear. Affected woody breast muscle exhibits muscle fiber degeneration/regeneration, connective tissue accumulation, and adverse morphological changes in mitochondria. Ribonucleotide reductase (RNR) is an enzyme for the synthesis of dNTP, which is important for mitochondria DNA content (mtDNA). RNR consists of two subunits: RRM1/RRM2. A decrease in RRM2 is associated with a decrease in mtDNA and mitochondria proteins, leading to impaired ATP production. The objective of this study was to investigate potential RNR differences between woody breast (WB) and normal (N) breast muscle by examining RRM2 expression and associated pathways. Gene expression and enzyme activities were examined by qPCR and commercial kits. Results showed that RRM2 expression reduced for WB (p = 0.01) and genes related to mitochondria, including ATP6 (p = 0.03), COX1 (p = 0.001), CYTB (p = 0.07), ND2 (p = 0.001) and ND4L (p = 0.03). Furthermore, NDUFB7 and COX 14, which are related to mitochondria and ATP synthesis, tended to be reduced in WB. Compared to N, GLUT1 reduced for WB (p = 0.05), which is responsible for glucose transport in cells. Consequently, PDK4 (p = 0.0001) and PPARG (p = 0.008) increased in WB, suggesting increased fatty acid oxidation. Citric synthase activity and the NAD/NADH ratio (p = 0.02) both reduced for WB, while WB increased CHRND expression (p = 0.001), which is a possible indicator of high reactive oxygen species levels. In conclusion, a reduction in RRM2 impaired mitochondria function, potentially ATP synthesis in WB, by increasing fibrosis and the down-regulation of several genes related to mitochondria function.

Islamic Financial Performance Index: The role of Islamic Intellectual Capital

This research is intended to analyze the influence of Islamic Intellectual Capital on the Islamic Financial Performance Index of Islamic Commercial Banks in Indonesia. The used method in this research is causality method. The data were analyzed through panel data regression. The results indicate the level of Islamic Intellectual Capital of Islamic Commercial Banks in Indonesia is high. Furthermore, the Islamic Financial Performance Index indicator with a very high level are Islamic Investment Ratio or Halal Investment and Islamic Income Ratio. The high-level indicator is Equitable Distribution Ratio. The moderate level indicator is Profit Sharing Ratio. The low-level indicator is the Directors-Employees welfare ratio. The very low-level indicator is the Zakat Performance Ratio. Generally, the financial performance of Islamic Commercial Banks in Indonesia based on the Islamic Financial Performance Index has a fairly high level. In addition, Islamic Intellectual Capital has a positive and significant influence on the Islamic Financial Performance Index of Islamic Commercial Banks in Indonesia. The condition shows if the quality of employees, technology, operational systems and good relations of Islamic banks and their partners are high, it will encourage Islamic banks to have high financial performance based on Islamic Financial Performance Index. This research is expected to provide benefits in relation to the measurement of financial performance based on the Islamic Financial Performance Index of Islamic Commercial Banks in Indonesia.

Comprehensive assessment of open source software ecosystem health

Recent surveys expose that the use of Open Source Software (OSS) is increasingly becoming a need for organizations in their development projects. However, deciding a proper OSS to be adopted or to contribute to its development is a complex and error-prone task. Analyzing the OSS ecosystem (OSSECO) health may help providing information about: (1) the OSS itself (number of commits, days after the last release, etc.); and (2) their main actors (number of contributors, partners, etc.). There exist proposals that go further and provide aggregated high-level indicators (e.g. visibility as an aggregation of number of community events, number of partners, and other metrics). Nevertheless, there is a lack of useful OSSECO analysis tools to ease the decision making on which OSSECO has the health required by a potential OSS adopter or contributor. In this work, we provide OSS-CARE (OSSeCo heAlthy monitoR and analysEr), an OSS-independent, fully automatic, and real-time framework to assess OSSECO’s health. OSS-CARE supports defining the ecosystem health objectives of potential OSS adopters, OSS contributors, and even OSS managers to inspect their provided health. These objectives are defined based on a well-established model characterizing health metrics that can be potentially aggregated by using a Bayesian network technique. Moreover, the integrated monitoring and analysis components perform an automated assessment of OSSECO’s health by checking the fulfillment of the required health objectives. Furthermore, the result is shown in an appealing dashboard that may ease the complex decision making of which OSS to choose.

Sustainability Evaluation of Chinese Capital Cities Based on Urban Geographic Environment Index

Environmental assessments are important tasks for the long-term, sustainable development of cities. With the rapid urbanization in China, it is crucial to establish a City Sustainability Index (CSI) and evaluate the environmental conditions in major cities. However, most of the existing major sustainability indices/indicators are not able to assess cities at diverse levels of development using common axes of evaluation. In this work, we incorporate urban built-up areas extracted from high-resolution remote sensing images as indicators to measure the degree of urban development in city sustainability evaluation and propose a comprehensive index, i.e., the Urban Geographic Environment Index (UGEI). In order to eliminate the impact of urban development levels, UGEI mainly consists of area-averaged indices which are calculated from original indices and urban built-up areas. We adopt a comprehensive weighting method by using the analytic hierarchy process (AHP) method to weigh the high-level indicators and using the entropy weighting method to weigh low-level indicators. We evaluate the environmental conditions of 30 China’s provincial capitals from the aspects of pressure, state, response, and overall status. In addition, we analyze how diverse types of indicators affect the values of UGEIs. The major findings are as follows: (1) About half of the provincial capitals in China have poor sustainability in environmental conditions, and more environmental protection measures should be taken in developing cities; (2) the environmental conditions of the provincial capitals in China present a four-region distribution pattern, namely, the northeastern coastal region, northwest inland region, southwest region, and southeast region; (3) and indices based on urban built-up extents can be common axes of evaluation for cities at diverse levels of development. The proposed UGEI can serve as an effective and reliable index for sustainability evaluation in environmental conditions.

Left-wing Violent Extremism: Identifying Precursors and Growth in New Zealand

As attention to right-wing violent extremism intensifies, accusations of left-wing violent extremism have become more frequent. There is, however, very little evidence of this violence occurring in New Zealand today and international research suggests mobilisation to violence among left-wing extremists is currently uncommon compared to right-wing or other types of extremism, is concentrated in a limited number of comparable countries, and is rarely fatal. This article argues that left-wing violent extremism is not currently occurring in New Zealand because several politico-social factors, which give rise to extremist violence, are absent. Yet it would be a mistake to believe that New Zealand is immune from left-wing violent extremism, especially stochastic terrorism. We, therefore, suggest an ongoing appreciation of several high-level indicators of nascent political violence would enable law enforcement and other security professionals to remain aware of politico-social developments and the potential for violent extremism without overly intrusive monitoring of individuals.

Developing Indicators to Measure the Implementation of the Western Cape Alcohol Harms Reduction Strategy in South Africa

This manuscript describes a process to develop a set of indicators to monitor and evaluate the implementation of the Western Cape Alcohol-Related Harms Reduction (AHR) White Paper in South Africa and provide a final set of indicators. Drawing on the framework in Andréasson et al. (2009), a logic model with categories and types of indicators (i.e. prevention, determinants, consumption, and alcohol-related harms) was used to develop an initial set of 255 indicators. The methodological process followed involved a) scoping of a large electronic database maintained by the South African Medical Research Council, b) a comprehensive literature review and, c) reaching out to18 international key informants. Iterative communications with stakeholders from diverse government entities via email, telephone calls and individual and multi-person face-to-face meetings, together with a consensus process involving the study team was used to refine the indicators. The final set included 176 indicators; 108, (61.4%) of these were “core” indicators, and 68 (38.6%) were “expanded” indicators, meaning they added to the core indicators in given areas which would be useful to have but are of a lower priority or are likely to be less easy to obtain. Of the core indicators, 45 (42.4%) were deemed by policy makers/researchers in the Premier’s office as “high-level indicators,” denoting that they were the most essential. This manuscript demonstrates that it is possible to develop evidence-based, location-specific indicators to evaluate policy implementation.

Stress Indicators Among 21st Century University Students

Introduction: Pursuing higher education has always been considered to be stressful as students need to adapt to new social and academic environment. Higher education in recent years has shifted from teacher centred authoritarian approach to student centred learning with amicable learning environment. In this changing scenario, this study aims to identify the indicators of stress and stress levels among 21st century university students and fathom the demographic factors influencing it. Method: A cross-sectional survey was conducted on students attending a private university in Malaysia using Stress Indicators Questionnaire. The data was analysed with descriptive and inferential statistical tests. Results: A total of 1050 university students aged between 18-30 years from different faculties voluntarily participated in the study. All respondents reported stress varying from very low to dangerous levels. Among the indicators of stress, sleep and emotional indicators were at dangerous levels, physical indicators and personal habits were at high level and behaviour indicators were perceived at medium level. A significant difference in total stress score between students of different age groups and ethnicity were observed, while no significant difference was noted with regards to gender. Conclusion: This study reveals that various indicators of stress are prevalent among the present-day university students. It may help guide policy makers and teachers in early identification of stress among their pupils and plan effective strategies aimed at balancing a good quality of life and academic achievement for the learners in institutions of higher learning.