High Level Of Confidence Research Articles

Air quality of health facilities in Spain

The present study examines indoor air pollution in health facilities, focusing on compounds from various sources, such as industrial products, healthcare activities and building materials. It assesses chemical and microbiological concentrations in two public hospitals, two public healthcare centres, and one public health laboratory in Spain. Measurements included indoor air quality, microbiological contaminants, ambient parameters and non-target analysis across ten different locations. Outdoor air quality was also assessed in the surroundings of the hospitals.The results showed that around 350 substances were tentatively identified at a high confidence level, with over 50 % of compounds classified as of high toxicological risk. Three indoor and 26 outdoor compounds were fully confirmed with standards. These confirmed substances were linked to medical, industrial and agricultural activities. Indoor Air Quality (IAQ) results revealed that CO, CO2, formaldehyde (HCHO), O3 and total volatile organic compounds (TVOCs) showed average values above the recommended guideline levels in at least one of the evaluated locations. Moreover, maximum concentrations detected for CO, HCHO, O3 and TVOCs in hospitals surpassed those previously reported in the literature. SARS-CoV-2 was detected in three air environments, corresponding to COVID-19 patient areas. Fungi and bacteria concentrations were acceptable in all assessed locations, identifying different fungi genera, such as Penicillium, Cladosporium, Aspergillus, Alternaria and Botrytis.

Transcultural adaptation and validation of the DASH questionnaire in Mexican healthy volunteers and patients with neurogenic disorders of the upper extremity

The Disability of the Arm, Shoulder and Hand (DASH) questionnaire assesses the impact of upper extremity disorders on quality of life. However, its use in the Mexican population has not been formally validated. To conduct a cultural adaptation and validation of the DASH questionnaire to evaluate the perspective of patients with neurogenic disorders of the upper extremity regarding the impact on their quality of life. We performed an adaptation of the Spanish version of the DASH questionnaire to the Mexican vocabulary and applied it to 478 volunteers. Ceiling effect, floor effect, item-total correlation, descriptive statistics of items and total score, internal consistency, precision, cross-sectional and longitudinal validity were estimated by comparing healthy controls and affected individuals with different disability levels. Our DASH questionnaire version was equivalent to those previously approved and showed homogeneity of the items with respect to the total value of the questionnaire (Cronbach's alpha > 0.96). In addition, it showed an accuracy of 7.25 points and the crosssectional and longitudinal validity was documented with significant differences between groups and subgroups with distinct disability levels. The DASH questionnaire can be used with a high level of confidence in the Mexican population.

Deep Learning Reconstructed New-Generation 0.55 T MRI of the Knee-A Prospective Comparison With Conventional 3 T MRI.

The aim of this study was to compare deep learning reconstructed (DLR) 0.55 T magnetic resonance imaging (MRI) quality, identification, and grading of structural anomalies and reader confidence levels with conventional 3 T knee MRI in patients with knee pain following trauma. This prospective study of 26 symptomatic patients (5 women) includes 52 paired DLR 0.55 T and conventional 3 T MRI examinations obtained in 1 setting. A novel, commercially available DLR algorithm was employed for 0.55 T image reconstruction. Four board-certified radiologists reviewed all images independently and graded image quality, noted structural anomalies and their respective reporting confidence levels for the presence or absence, as well as grading of bone, cartilage, meniscus, ligament, and tendon lesions. Image quality and reader confidence levels were compared ( P < 0.05, significant), and MRI findings were correlated between 0.55 T and 3 T MRI using Cohen kappa (κ). In reader's consensus, good image quality was found for DLR 0.55 T MRI and 3 T MRI (3.8 vs 4.1/5 points, P = 0.06). There was near-perfect agreement between 0.55 T DLR and 3 T MRI regarding the identification of structural anomalies for all readers (each κ ≥ 0.80). Substantial to near-perfection agreement between 0.55 T and 3 T MRI was reported for grading of cartilage (κ = 0.65-0.86) and meniscus lesions (κ = 0.71-1.0). High confidence levels were found for all readers for DLR 0.55 T and 3 T MRI, with 3 readers showing higher confidence levels for reporting cartilage lesions on 3 T MRI. In conclusion, new-generation 0.55 T DLR MRI provides good image quality, comparable to conventional 3 T MRI, and allows for reliable identification of internal derangement of the knee with high reader confidence.

Revolutionizing breast cancer Ki-67 diagnosis: ultrasound radiomics and fully connected neural networks (FCNN) combination method.

This study aims to assess the diagnostic value of ultrasound habitat sub-region radiomics feature parameters using a fully connected neural networks (FCNN) combination method L2,1-norm in relation to breast cancer Ki-67 status. Ultrasound images from 528 cases of female breast cancer at the Affiliated Hospital of Xiangnan University and 232 cases of female breast cancer at the Affiliated Rehabilitation Hospital of Xiangnan University were selected for this study. We utilized deep learning methods to automatically outline the gross tumor volume and perform habitat clustering. Subsequently, habitat sub-regions were extracted to identify radiomics features and underwent feature engineering using the L1,2-norm. A prediction model for the Ki-67 status of breast cancer patients was then developed using a FCNN. The model's performance was evaluated using accuracy, area under the curve (AUC), specificity (Spe), positive predictive value (PPV), negative predictive value (NPV), Recall, and F1. In addition, calibration curves and clinical decision curves were plotted for the test set to visually assess the predictive accuracy and clinical benefit of the models. Based on the feature engineering using the L1,2-norm, a total of 9 core features were identified. The predictive model, constructed by the FCNN model based on these 9 features, achieved the following scores: ACC 0.856, AUC 0.915, Spe 0.843, PPV 0.920, NPV 0.747, Recall 0.974, and F1 0.890. Furthermore, calibration curves and clinical decision curves of the validation set demonstrated a high level of confidence in the model's performance and its clinical benefit. Habitat clustering of ultrasound images of breast cancer is effectively supported by the combined implementation of the L1,2-norm and FCNN algorithms, allowing for the accurate classification of the Ki-67 status in breast cancer patients.

Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review.

Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.

Implementasi Model Pembelajaran Berbasis Proyek dalam Meningkatkan Kreativitas Mahasiswa

Project-Based Learning Models (PBP) have received significant attention in higher education contexts due to their potential to stimulate student creativity. This research explores the impact of PBP implementation in increasing student creativity. Through a qualitative approach, data was collected from research participants who were students who had participated in learning experiences with PBP. The research results showed that the majority of students expressed increased creative skills, including the ability to think out-of-the-box, face challenges with innovative solutions, and integrate various concepts to create new solutions. In addition, they also feel more motivated and actively involved in learning because the projects they participate in allow them to be involved in situations that are similar to real life. Collaboration between students also plays an important role in stimulating creativity, enabling the exchange of ideas, mutual support, and exploring innovative solutions. Lecturers and educational policy makers need to consider integrating PBL in curriculum design and learning practices to prepare students to face the demands of an increasingly complex world of work with high levels of creativity and confidence. In conclusion, PBP not only increases students' creativity, but also helps them apply theoretical knowledge in relevant and real contexts.

Role of Metacognitive Confidence Judgments in Curiosity: Different Effects of Confidence on Curiosity Across Epistemic and Perceptual Domains.

Previous research suggests that curiosity is sometimes induced by novel information one has no relevant knowledge about, but it is sometimes induced by new information about something that one is familiar with and has prior knowledge about. However, the conditions under which novelty or familiarity triggers curiosity remain unclear. Using metacognitive confidence judgments as a proxy to quantify the amount of knowledge, this study evaluates the relationship between the amount of relevant knowledge and curiosity. We reviewed previous studies on the relationship between subjective curiosity and confidence and reanalyzed existing large-sample data. The findings indicate that the relationship between curiosity and confidence differs depending on the nature of the stimuli: epistemic versus perceptual. Regarding perceptual stimuli, curiosity is stronger when individuals have lower confidence levels. By contrast, for epistemic stimuli, curiosity is stronger when individuals have higher confidence levels. These results suggest that curiosity triggered by perceptual stimuli is based on perceived novelty, whereas that triggered by epistemic stimuli is based on familiarity with prior knowledge.

Evaluating inhaler technique, patient preferences and opportunities for improvement in hospitals in the UK

Inhalers are a key aspect of managing airways disease. With effective use, they can reduce symptoms, reduce the frequency of exacerbations and thus reduce usage of healthcare services. Inhalers are associated with a significant carbon footprint, accounting for 3% of NHS' carbon emissions. We aimed to audit inhaler technique, patient preferences and inhaler prescribing and disposal to identify areas for improving the sustainability of respiratory care. An audit tool was created, and patient interviews conducted across eight different sites. Our data demonstrate that inhaler users, while self-reporting high levels of confidence in their inhaler technique, frequently make errors in inhaler technique. Additionally, the majority of patients considered the carbon footprint of their inhalers important and would consider changing to a lower carbon alternative. The majority of patients surveyed were not disposing of their inhalers correctly. This short audit has identified key areas for improvement in the quality and sustainability of respiratory care.

Examining Students’ Self-Regulation Skills, Confidence to Learn Online, and Perception of Satisfaction and Usefulness of Online Classes in Three Suggested Online Learning Environments that Integrates ChatGPT

This study aims to investigate students’ self-regulation skills, confidence to learn online, and perception of satisfaction and usefulness of online classes in three learning environments that integrates ChatGPT. In this study, a quasi-experiential design was used to compare three online learning environments that integrate ChatGPT (independent, peer, and group). A total of 100 undergraduate students were randomly assigned to these three groups. Three questionaries’ were used for data collection. The results showed that the self-regulation levels were high among the participants in these three online ChatGPT groups. However, learning in peer and group environments were more effective in developing self-regulation skills than learning independently. This research also found that the participants in the peer and group learning environments had high levels of confidence to learn online compared to the participants in the independent group. The results also showed that the participants in the peer learning group had the highest scores of perception of satisfaction and usefulness of online classes compared to the participants in the independent and group learning environments. The findings of this study support the notion that integrating ChatGPT within peer groups can enhance students' perception of satisfaction and usefulness of online classes. Educators should explore ways to leverage ChatGPT to facilitate meaningful interactions and collaboration among students, thereby increasing their satisfaction and engagement with online learning materials and activities.

Unveiling the Mental Toughness and Performance Resilience of Table Tennis Athletes

This study examined the psychological resilience and mental fortitude of Chinese table tennis athletes, specifically analyzing their demographic characteristics. The sample comprised predominantly of athletes aged 18 to 24, with a majority of female participants and a notable proportion having less than one year of expertise in the sport. Athletes assessed their mental toughness dimensions, such as commitment, control, confidence, and challenge, as being of average level. Noticeable disparities in mental resilience evaluations were noted among various age cohorts, genders, and levels of professional expertise. In terms of age, athletes between the ages of 18 and 24 demonstrated greater dedication and self-regulation, whereas female athletes had higher levels of confidence and dedication. The performance resilience tests indicated that the scores were moderate to slightly above average in many categories, indicating a well-balanced impression of their skills to withstand challenges. Significantly, the components of performance resilience, including awareness, physiology, emotions, and mastery, exhibited notable variations depending on age, gender, and years of experience. Moreover, a significant correlation was discovered between the characteristics of mental toughness and the ability to bounce back from setbacks, underscoring the significance of mental conditioning in improving athletes' capacity to surmount challenges and attain peak performance. These findings highlight the necessity of customized mental training programs to improve psychological resilience and performance among Chinese table tennis athletes. When developing interventions, coaches and sports psychologists should take into account the age, gender, and level of experience of players.

The Impacts of Explicit Strategy Instruction on Reading Performance from Students Perspective: A Case Study

This paper reported on part of a larger study to explore how Vietnamese non-English major students perceived the impacts of explicit strategy instruction (ESI) on reading comprehension. Instruction on reading strategies was conducted for 6 weeks in which students were taught explicitly previewing and predicting, skimming, scanning, guessing the meaning of the unknown words from the context and summarizing strategies. Data were collected from forty-five non-English major students at a university in Vietnam through group interviews and learning reflections. Three semi-structured interviews were conducted in groups of three to four students, and thirty-nine learning reflections were collected to obtain in-depth information about the impact of the ESI. The findings revealed that, after the instruction, the students reported using various reading strategies in four strategy categories, namely problem-solving, global, support and local strategies. In addition, the ESI was perceived to be cognitively beneficial, as students reported heightened awareness of using reading strategies in reading comprehension, expanded reading strategy repertoire, greater reading fluency, and higher reading scores. From a non-cognitive affective perspective, students reported that the ESI motivated them to read with a higher level of confidence and become more autonomous in reading in English. The study offers implications for teachers, students and materials writers in teaching and learning English reading skills in non-English major learning contexts and perhaps in other settings.

Effectiveness of school oral health programs in children and adolescents: an umbrella review.

To evaluate the systematic reviews assessing the effectiveness of any type of school-based oral health programs in children and adolescents. A two-staged search strategy comprising electronic databases and registries based on systematic reviews was employed to evaluate the effectiveness of school-based interventions. The quality assessment of the systematic reviews was carried out using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) tool. The Corrected Covered Area was used to evaluate the degree of overlap. Nine reviews were included in this umbrella review. The Critical Covered Area reported moderate overlap (5.70%) among the primary studies. The assessment of risk of bias revealed one study with a high level confidence; one with moderate whereas all other studies with critically low confidence. Inconclusive evidence related to improvements in dental caries and gingival status was reported whereas, plaque status improved in a major proportion of the reviews. Knowledge, attitude, and behavior significantly increased in students receiving educational interventions when compared to those receiving usual care. The evidence points to the positive impact of these interventions in behavioral changes and clinical outcomes only on a short term basis. There is a need for long-term follow-up studies to substantiate the outcomes of these interventions.

Enhancing clayey soil performance with lime and waste rubber tyre powder: Mechanical, microstructural, and statistical analysis

Nowadays, for soil stabilisation and cleaner production of geo-composites, the possibility of utilizing waste rubber is in vogue. The present paper deals with experimentally investigating the mechanical and micro-structural characteristics of weak Indian clayey soil partially substituted with lime (0–3.5%) and waste rubber tyre powder (0–15%). It was observed that, with increasing lime and rubber powder content, the plasticity index of the soil decreases. The shear strength and compaction testing results reveal that adding lime and rubber tyre powder (RTP) enhances the geotechnical performance of clayey soil up to an optimum dosage value. Also, the tri-axial shear testing was performed to obtain stress-strain curves for all considered soil mixes. For modified clayey soil containing 3% lime and 12.5% rubber powder, the cohesion values and bearing capacities improved phenomenally by 36.1% and 88.6% respectively, when compared to clayey soil. Further for this mix, SEM analysis reveals a compacted microstructure which improves dry-density and California's bearing ratio among all modified mixes. The novel co-relations upon regression analysis are found able to predict plasticity index, dry density, bearing capacity and shear strength with higher confidence levels. Overall, the cost-benefit analysis worked out to obtain the optimum cost of construction of footings and flexible pavement shows cost deductions up to 19% and 39% respectively while utilizing modified clay soil mixes containing 3% lime and 12.5% rubber powder in subgrade, ultimately making production stronger, cheaper and environment friendly.

Financial worry and government responses to the COVID-19 pandemic in 88 Countries: Did public confidence in National Governments matter?

During the COVID-19 pandemic, governments implemented various measures to control the spread of the virus, enhance healthcare systems, and mitigate the economic impact of these actions. In this study, we investigate how government responses to COVID-19, in terms of stringency and economic support, affected individuals' financial worries in 88 economies. We also investigate how the relationship between these variables was affected by the public’s confidence in the government. Our results suggest that greater stringency was associated with increased financial worry, irrespective of public trust in the government. Meanwhile, the impact of economic support policies varied with the level of public trust in the government. In countries where citizens reported high levels of confidence in their government, economic support to households helped to alleviate financial worry. In countries with low confidence levels, the support policies had no statistically significant impact.

Russian Citizents’ Attitute Towards Private Property: Myths and Contradictions

The article analyzes the attitude of Russian citizens to the institution of private property. The author estimates the level of confidence and respect of people to this institution, perception of their property right protection and risks connected with property management. The empiric base of the research was formed by findings of the sociological survey conducted in 2023 among 542 respondents of different age groups. The data provided an opportunity to identify common features in perceiving the institution of private property by Russian citizens, their expectation concerning this institution in the long run. The research findings refuted a number of stereotypes formed in society concerning perception of private property by people, who demonstrated rather high level of confidence to the institution of private property and its inviolability. At the same time the majority of respondents today follow the saving model aimed at long-term accumulation and increasing their assets to ensure sustainable standard of life in the future.

Mobilizing stakeholders for implant removals in Burkina Faso using landscape assessment data

BackgroundSuccessful efforts to encourage uptake of subdermal contraceptive implants, with a lifespan of three to five years, necessitate planning to ensure that quality removal services are available when desired. In Burkina Faso, implant use has tripled over the past 8 years and now comprises almost half of the contraceptive method mix. Population Monitoring for Action (PMA) surveys identified barriers to obtaining quality removal when desired, particularly when the implant is not palpable, or providers lack needed skills or supplies. The Expanding Family Planning Choices (EFPC) project supported ministries of health in four countries with evaluation and strengthening of implant removal services.MethodsAn implant removal landscape assessment was conducted at 24 health facilities in three regions of Burkina Faso with high implant use that included provider observations of implant removal, interviews with providers and health facility managers, and facility readiness surveys. The project used landscape data to mobilize stakeholders through a series of participatory workshops to develop a collaborative roadmap and commit to actions supporting quality implant removals.ResultsLandscape findings revealed key gaps in provision of quality removal services, including high levels of provider confidence for implant insertion and removal (82% and 71%, respectively), low competence performing simple and difficult removals (19.2% and 11.1%, respectively), inadequate supplies and equipment (no facilities had all necessary materials for removal), lack of difficult removal management systems, and a lack of standard data collection tools for removal. Exposure to the data convinced stakeholders to focus on removals rather than expanding insertion services. While not all roadmap commitments were achieved, the process led to critical investments in quality implant removals.ConclusionLandscape data revealed that facilities lack needed supplies and equipment, and providers lack skills needed to perform quality implant removals, limiting client reproductive choice. Disseminating this data enabled stakeholders to identify and commit to evidence-based priority actions. Stakeholders have since capitalized on program learnings and the roadmap, including following MOH guidance for implant removal supplies and health provider training. Our experience in Burkina Faso offers a replicable model of how data can direct collective action to improve quality of contraceptive implant removals.

Role of surgical simulation on self-reported confidence level on cardiothoracic surgical trainees.

Simulated self-practice using simulation models could improve fine motor skills and self confidence in surgical trainees. The purpose of this study is to evaluate on self-reported confidence level in cardiothoracic surgical trainees by using surgical simulation models. We conducted a cross-sectional study on all surgeons (n=10) involved in MIS simulation training. All surgeons are required to perform on three minimally invasive surgery (MIS) procedures (Mitral Valve Repair, Mitral Valve Replacement and Aortic Valve Replacement). A questionnaire was designed based on two existing scales related to self-confidence, the surgical self-efficacy scale [SSES] and the perceived competency scale [PCS]. We assessed their self-confidence (before and after training) in the use of simulation in MIS procedures using rating scales 1-5. The mean score was calculated for each domain and used as the predictor variable. We also developed six questions (PCS) using Objective Structured Assessment of Technical Skills (OSAT) related to each domain and asked participants how confident they were after performing each MICS procedure. The mean score was 4.7 for all assessed domains, except "knowledge" (3.8). Surgeons who had performed one or more MIS procedures had higher scores (P<0.05). There was no correlation between the number of MIS procedures performed and self-confidence scores. The results indicate that the cardiac surgery training based on MIS simulation improves trainees and consultants in terms of the level of self-confidence. Although surgeons generally have high levels of self-confidence after simulation training in MIS cardiac procedures, there is still room for improvement with respect to technical skills related to the procedure itself and its results.

Geospatial forest fire risk assessment and zoning by integrating MaxEnt in Gorkha District, Nepal

Forest fires are an imminent danger to natural forest ecosystems, and carrying out zoning studies and forest fire risk assessments are of great practical significance in steering fire prevention, minimizing fire incidents, and limiting the environmental consequences of fire. Using the Gorkha district of Nepal as a case study, this study used remotely sensed high-temperature fire data as the forest fire sample. Nine parameters related to topography, climatic conditions, vegetation, and human intervention were used as environmental variables affecting fire occurrence. Next, a MaxEnt forest fire risk assessment model was generated with GIS and R, which analysed the contribution, significance, and responses of environmental variables to the forest fire in Gorkha District. The findings demonstrate that (1) following a test of sample locations for forest fires, the MaxEnt model has excellent relevance and practicality when applied to fire risk assessment; (2) Out of 2747 fire points in the forest, only 110 Spatio-temporally independent fire points were used for the model building having high and normal confidence level. Regarding Area Under Curve (AUC) values, the training data yielded results of 0.875, while the test data produced acceptable results of 0.861 with a standard deviation of 0.0322; (3) the importance of climatic and Land Use Land Cover (LULC) variables to forest fire are 56.2 % and 32.9 %, respectively, and their contribution to forest fire are 32 % and 47.6 %, respectively. (4) There are numerous and intricate ways that environmental factors influence forest fires. The forest fire response curves to the nine chosen environmental variables are complex and nonlinear rather than linear; Maximum temperature of the warmest month (bio_5), Isothermality (bio_3), Precipitation of Driest Quarter (bio_17) and mean Diurnal Range (bio_2) bear a nonlinear positive link with the possibility of forest fires. In contrast, elevation, slope, temperature seasonality (bio_4), distance from the settlement, and LULC have a favorable stimulating response to the possibility of forest fires within an appropriate interval. (5) In Gorkha, there are geographical differences in the risk of forest fires. Only 12.83 % of the whole area is made up of areas at significantly high risk or above, compared to 87.17 % for high-risk and below.

Longitudinal changes in serum immunoglobulin G testing in patients with fibrotic avian hypersensitivity pneumonitis

BackgroundEvaluation of the antigen responsible for fibrotic hypersensitivity pneumonitis (HP) is challenging. Serum immunoglobulin (Ig) G testing against HP-associated antigens is performed. Although single-serum IgG testing has been investigated, multiple-serum IgG testing has not yet been studied.MethodsThis study included patients who underwent histopathological examination and positive inhalation challenge test as well as those with moderate or high HP guideline confidence level. Serum IgG testing against pigeon serum was conducted twice using two methods: enzyme linked-immunosorbent assay (ELISA) and ImmunoCAP. The association between changes in serum IgG antibody titers and changes in forced vital capacity (FVC) and other parameters was investigated.ResultsIn this study, 28 patients (mean age, 64.5 years; mean FVC, 85.3%) with fibrotic avian HP were selected, of whom 20 and 8 underwent surgical lung biopsy and transbronchial lung cryobiopsy, respectively. Of the 28 patients, 19 had been keeping birds for more than 6 months. A correlation was observed between the annual changes in serum IgG antibody titers by ELISA and changes in relative FVC (r = − 0.6221, p < 0.001). Furthermore, there was a correlation between the annual changes in serum IgG antibody titers by ImmunoCAP and changes in relative FVC (r = − 0.4302, p = 0.022). Multiple regression analysis revealed that the change in serum IgG antibody titers by both ELISA and ImmunoCAP also influenced the relative FVC change (p = 0.012 and p = 0.015, respectively). Moreover, 13 patients were given additional treatments between the first and second blood test; however, the additional treatment group was not significantly different in relative FVC change compared to the group with no additional treatment (p = 0.982).ConclusionsIn patients with fibrotic avian HP, the annual changes in serum IgG testing were correlated with FVC changes, highlighting the importance of serum IgG testing over time.

Dissecting subjective L2 (un)willingness to communicate among EFL learners: a Q methodology study

ABSTRACT This study used Q methodology to explore the subjective perspectives of English as a Foreign Language (EFL) learners regarding sources of willingness to communicate (WTC). A sample of 40 undergraduate students enrolled in an English language teaching program at a Turkish university was obtained. Based on their shared viewpoints, the participants were clustered into three groups: self-assured communicators, motivated communicators, and nervous communicators. Self-assured communicators exhibited high levels of self-confidence, while motivated communicators displayed strong and unwavering motivation to improve their speaking skills. Nervous communicators, on the other hand, showed noticeable signs of anxiety, impeding their WTC. This study provides evidence that an amalgamation of internal and external factors works in synergy to shape EFL learners’ WTC in the classroom. Recognising this interplay can lead to the development of targeted interventions and instructional approaches, improving L2 learners’ communicative behaviours. Understanding and addressing learners’ subjective experiences, particularly in relation to self-confidence, motivation, and anxiety, are key elements in enhancing their WTC and overall language proficiency.