Main Study Sample Research Articles

Automated free speech analysis reveals distinct markers of Alzheimer’s and frontotemporal dementia

Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer’s disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients’ scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.

Virtual Scribes and Physician Time Spent on Electronic Health Records

Time on the electronic health record (EHR) is associated with burnout among physicians. Newer virtual scribe models, which enable support from either a real-time or asynchronous scribe, have the potential to reduce the burden of the EHR and EHR-related documentation. To characterize the association of use of virtual scribes with changes in physicians' EHR time and note and order composition and to identify the physician, scribe, and scribe response factors associated with changes in EHR time upon virtual scribe use. Retrospective, pre-post quality improvement study of 144 physicians across specialties who had used a scribe for at least 3 months from January 2020 to September 2022, were affiliated with Brigham and Women's Hospital and Massachusetts General Hospital, and cared for patients in the outpatient setting. Data were analyzed from November 2022 to January 2024. Use of either a real-time or asynchronous virtual scribe. Total EHR time, time on notes, and pajama time (5:30 pm to 7:00 am on weekdays and nonscheduled weekends and holidays), all per appointment; proportion of the note written by the physician and team contribution to orders. The main study sample included 144 unique physicians who had used a virtual scribe for at least 3 months in 152 unique scribe participation episodes (134 [88.2%] had used an asynchronous scribe service). Nearly two-thirds of the physicians (91 physicians [63.2%]) were female and more than half (86 physicians [59.7%]) were in primary care specialties. Use of a virtual scribe was associated with significant decreases in total EHR time per appointment (mean [SD] of 5.6 [16.4] minutes; P < .001) in the 3 months after vs the 3 months prior to scribe use. Scribe use was also associated with significant decreases in note time per appointment and pajama time per appointment (mean [SD] of 1.3 [3.3] minutes; P < .001 and 1.1 [4.0] minutes; P = .004). In a multivariable linear regression model, the following factors were associated with significant decreases in total EHR time per appointment with a scribe use at 3 months: practicing in a medical specialty (-7.8; 95% CI, -13.4 to -2.2 minutes), greater baseline EHR time per appointment (-0.3; 95% CI, -0.4 to -0.2 minutes per additional minute of baseline EHR time), and decrease in the percentage of the note contributed by the physician (-9.1; 95% CI, -17.3 to -0.8 minutes for every percentage point decrease). In 2 academic medical centers, use of virtual scribes was associated with significant decreases in total EHR time, time spent on notes, and pajama time, all per appointment. Virtual scribes may be particularly effective among medical specialists and those physicians with greater baseline EHR time.

Exploring the Preferences of the Australian Public for Antibiotic Treatments: A Discrete Choice Experiment.

Identify Australian public preferences for antibiotic treatments in the context of antibiotic stewardship. A discrete choice experiment (DCE) was conducted in Australia to investigate the importance of seven attributes associated with antibiotic treatments and related stewardship practices: contribution to antimicrobial resistance (AMR), treatment duration, side effects, days needed to recover, days before taking antibiotics, treatment failure and out-of-pocket costs. The DCE data were analysed using conditional logit, mixed logit and latent class conditional logit models. The relative importance of each attribute was calculated. A total of 1882 respondents completed the survey; the main study sample consist of 1658 respondents (mean age 48 years) who passed quality checks. All seven attributes significantly influenced respondents' preferences for antibiotic treatments. Based on the designed attribute levels in the DCE, on average, out-of-pocket costs (32.8%) and contribution to antibiotic resistance (30.3%) were the most important attributes, followed by side effects (12.9%). Days before starting medication was least important (3.9%). Three latent classes were identified. Class 1 (including respondents who were more likely to be older and more health literate; 24.5%) gave contribution to antibiotic resistance greater importance in treatment preferences. Class 2 (including respondents more likely to report poorer health; 25.2%) gave out-of-pocket costs greater importance. The remaining (50.4%), who were generally healthier, perceived side effects as the most important attribute. Despite concerted public awareness raising campaigns, our results suggest that several factors may influence the preferences of Australians when considering antibiotic use. However, for those more likely to be aware of the need to preserve antibiotics, out-of-pocket costs and limiting the contribution to antibiotic resistance are the dominant influence. Delays in starting treatment were not important for any latent class, suggesting public tolerance for this measure. These results could help inform strategies to promote prudent antibiotic stewardship.

Leveraging External Validation Data: The Challenges of Transporting Measurement Error Parameters.

Approaches to address measurement error frequently rely on validation data to estimate measurement error parameters (e.g., sensitivity and specificity). Acquisition of validation data can be costly, thus secondary use of existing data for validation is attractive. To use these external validation data, however, we may need to address systematic differences between these data and the main study sample. Here, we derive estimators of the risk and the risk difference that leverage external validation data to account for outcome misclassification. If misclassification is differential with respect to covariates that themselves are differentially distributed in the validation and study samples, the misclassification parameters are not immediately transportable. We introduce two ways to account for such covariates: (1) standardize by these covariates or (2) iteratively model the outcome. If conditioning on a covariate for transporting the misclassification parameters induces bias of the causal effect (e.g., M-bias), the former but not the latter approach is biased. We provide proof of identification, describe estimation using parametric models, and assess performance in simulations. We also illustrate implementation to estimate the risk of preterm birth and the effect of maternal HIV infection on preterm birth. Measurement error should not be ignored and it can be addressed using external validation data via transportability methods.

Longitudinal measurement invariance of the Working Alliance Inventory - Short form across coaching sessions

BackgroundThroughout the psychotherapeutic and coaching literature, the client-therapist or coach-coachee working alliance has been highlighted as key force driving positive outcome. The Working Alliance Inventory Short form (WAI-S) for coaching charts the quality of working alliance throughout coaching sessions and is broadly applied in coaching research. Due to a shortfall in research on psychometric properties of the WAI-S, the purpose of this study was to examine (a) if the theorized three-factor structure of the 12-item WAI-S forms a solid representation of the dimensions of working alliance in coaching, and (b) longitudinal measurement invariance (LMI) of the WAI-S.MethodData were collected in a two-wave study design comprising a main study sample of N = 690 Dutch coachees that completed the questionnaire at the first measurement, of which N = 490 also completed the questionnaire at the second measurement. Post hoc sensitivity analysis was performed based on the original sample, lacking additional information on covariates, and included both completers and dropouts, comprising N = 1986 respondents at T1, and N = 1020 respondents at T2.ResultsConfirmatory factor analyses evidenced best fit of the three-factor model in comparison to one-, and two-factor models at both time points. Despite the fact that multigroup confirmatory factor analysis detected non-invariant intercepts, our findings overall supported measurement invariance across coaching sessions.ConclusionsAs decisions in both clinical and scientific practices generally rely on outcome assessment of interpersonal change in scores on the same measure over time, we believe our findings to be of contributing value to the consolidation of interpretation and accuracy of scorings on the WAI-S in coaching.

The Effect of Using Podcasts and Vodcasts on Developing Ninth Graders’ Speaking Skills of the English Language

The study aimed to determine the effect of applying Podcasts and Vodcasts on developing speaking skills for Ninth-graders in King Abdullah II Schools for Excellence. The study used the quasi-experimental approach by dividing the study sample into three groups, which include the group of Podcasts (23) students, the group of Vodcasts (27) students, and the control group (25) students. An oral test scale for students' speaking skills was prepared, and its validity and reliability were verified by applying it to a pilot sample of (25) individuals from outside the main study sample. The results indicated that the use of Podcasts leads to statistically significant differences in the level of the Ninth-grade students' acquisition of speaking skills in the English language compared to their peers in the control group, which was taught in the conventional method. In the same context, the results indicated that using Vodcasts leads to statistically significant differences in the level of Ninth-grade students’ acquisition of speaking skills in the English language compared to their peers in the control group, which was taught in the conventional method. In addition, the results concluded that Vodcasts have a more significant positive effect on developing students' speaking skills when compared to Podcasts. Finally, several recommendations were suggested as the necessity of activating the use of podcasts and vodcasts in teaching speaking skills, as well as the need to re-review current English language curricula to include classroom activities consistent with the requirements of applying podcasts and vodcasts in teaching the English language.

The Use of Tobacco Industry Vaping Products in the UK and Product Characteristics: A Cross-Sectional Survey.

BackgroundTobacco industry (TI) companies have entered the UK e-cigarette (“vaping”) market in recent years. However, their motives and ambitions are unclear. This study explored how popular TI vaping products are and who uses them, and how they differ from independent products.MethodsSecondary analysis of data from a longitudinal web-based survey of smokers, ex-smokers, and vapers (n = 3883) in the UK in 2019. The main study sample consisted of daily and nondaily vapers, who were current or ex-cigarette smokers, and had stated the brand of their preferred e-cigarette device (n = 1202). Proportions using TI and independent brands were calculated and regression analysis assessed associations with sociodemographic and smoking/vaping characteristics between vapers of TI and independent products. Chi-square tests were used to analyze differences between TI and independent products.ResultsOverall, 53.4% used TI products. A university education (67.6%; adjOR = 1.54; 95% CI, 1.140–2.088), nondaily vaping (68.2%; adjOR = 1.39; CI, 1.029–1.880), and cigarette dependence (moderate, strong and very strong urges to smoke) were associated with using TI vaping brands. TI products used were less likely to be refillable (“open”) than independent brands (60.9% vs. 18.3%, chi-square = 228.98, p < .001), more likely to use nicotine salts (16.7% vs. 8.6%, chi-square = 25.04, p < .001) and tobacco flavors (23.8% vs. 17.9%, chi-square = 12.65, p < .001).ConclusionTI vaping products were popular in the UK, associations with product and user characteristics suggest that TI products may be less conducive to smoking cessation, although the findings were not always consistent.ImplicationsConsequences of regulations need to be carefully considered to ensure that independent producers are not more negatively impacted than tobacco industry producers, and to avoid reducing utility of products for smoking cessation.

Prevalence and Determinants of Transient Congenital Hypothyroidism in Children With Eutopic Gland in France: A Retrospective Cohort Study.

The increase in the incidence of congenital hypothyroidism (CH) reported worldwide may partly be explained by an increase in the transient form of CH. We aimed to estimate the proportion of transient CH (TCH) in France, and to identify associated neonatal and young child characteristics. We used probabilistic record linkage to link children with eutopic gland born between 2006 and 2012 recorded in the national French CH registry and the French national health data system (SNDS). Of the 703 children recorded, 484 (68.8%) were linked. We retrospectively examined reimbursement for oral levothyroxine (LT4) between January 1, 2006, and December 31, 2017. Children who had discontinued treatment for 6 months or more before December 31, 2017, were classified as having TCH. We used a Cox model to examine the factors associated with TCH. Among the main study sample (n = 471), 53.5% were female, 14.2% were preterm, and 13.8% had low birth weight. One-quarter (n = 111, 24.3%) had mild CH (thyroid-stimulating hormone [TSH] < 50 mU/L, serum) at diagnosis and a median LT4 dose at treatment initiation of 30 μg/day. One-third (n = 155, 32.9%) had TCH. Premature birth (adjusted hazard ratio = 2.1 [1.0-4.2]), a TSH < 50 mU/L at CH screening (7.4 [3.2-17.1]), LT4 dose received at 12 months of age (0.98 [0.97-0.99, P = 0.003]), congenital cardiac malformations (6.6 [1.5-29.0]), and year of birth (1.2 [1.1-1.4]) were all associated with TCH. One-third of the children had TCH, and it was associated with several characteristics at birth and postpartum. These data are useful for CH medical management and epidemiological surveillance.

Consideration of future consequences and predictability: Examining six health behaviors with different levels of perceived severity

ABSTRACT Research has shown that consideration of future consequences can successfully predict different health behaviors. Prior studies, however, have yielded inconsistent findings. This study aimed to address these inconsistencies by examining the associations between consideration of future consequences and different health behaviors involving different levels of severity. The main study sample consisted of 385 college students. Using a paper-and-pencil survey, a cross-sectional study was conducted. The survey addressed six behaviors under three health topics including vaccination (flu vaccination, HPV vaccination), smoking (smoking, signing for a smoke-free campus policy), and energy drink consumption (energy drink consumption, energy drink consumption mixed with alcohol). Behavioral status and consideration of future consequences were measured. Consideration of future consequences predicted health behaviors involving greater severity whereas it failed to predict health behaviors involving relatively less severity. This study found that the ability of consideration of future consequences to predict different health behaviors depends on the perceived severity associated with the behaviors.

Dental age estimation: Development and validation of a reference data set for Kuwaiti children, adolescents, and young adults

ObjectivesThis study was designed to establish a Reference Data Set for Dental Age Estimation of young Kuwaiti subjects. DesignDental Panoramic Tomographs of 1393 Kuwaiti children, adolescents, and young adults aged between 3 and 26 years were re-used to establish a Reference Data Set. The Tooth Development Stages described by Demirjian et al. in 1973 was used to assess all the teeth on the left side of the Maxilla and the Mandible. The Accuracy and Precision of Dental Age Estimation for Kuwaiti children and adolescents was investigated by calculating the age of children using 50 females and 50 males of known age separate from the main study sample. This was the Validation Sample. Summary data for the individual Tooth Development Stages, comprising the number, mean, and standard deviation were used to estimate the age of the subjects in the Validation Sample using the Simple Average Method to calculate the Dental Age. ResultsThere was no statistically significant difference between the Chronological Age and the Dental Age in males with a mean difference of 0.14 years (1.75 months). The difference in females was significant at −0.33 years (−4.1 months). ConclusionsThese data demonstrate that estimated Dental Age in Kuwaiti females is close, just over 4 months, and is very close, in males within 1.75 months of the Chronologic Age.

Measuring Students’ Perceptions of Teacher Involvement in Mathematics Homework Assignments: A Scale Development

This study aimed to develop a scale to determine students&amp;rsquo; perceptions of teacher involvement in mathematics homework assignments. An item pool (n = 30) was generated based on a literature review. Based on expert feedback, the number of items was reduced to 21 scored on a 5-point Likert-type scale. A draft named the &amp;ldquo;Scale of Teacher Involvement in Mathematics Homework Assignments (STIMHA)&amp;rdquo; was developed after the items were reviewed by a linguist. A pilot study was conducted with six middle school students to check for comprehensibility. The items were revised and finalized based on their feedback. The main study sample consisted of 751 middle school students from four schools in Demirci/Manisa in Turkey during the 2017-2018 academic year. Data were analyzed using the Statistical Package for Social Sciences (SPSS 24.0) and Analysis of Moment Structures (AMOS 21.0). Validity and reliability were established.

Direct and Indirect Effects of Difficulties in Emotion Regulation on Bullying in High School Adolescents

In an Egyptian context, in addition to identifying the direct and indirect effects of difficulties in emotion regulation on bullying, this study aims at identifying the order of bullying forms perceived by bullies and bullying victims. Moreover, the study aims at showing the differences of difficulties in emotion regulation among bullies, bullying victims and normal adolescents. The Bullying Scale and the Scale of the Difficulties in Emotion Regulation were implemented to the main study sample which includes 86 Egyptian adolescents in addition to 100 adolescents for validation sample. The regression analysis mainly used to identify the direct and indirect effects of difficulties in emotion regulation and various forms of bullying among adolescents in addition to various statistical methods to identify other objectives. The bullying forms perceived by bullies were social bullying, psychological bullying and physical bullying respectively. Bullying forms perceived by bullying victims were physical bullying, psychological bullying and social bullying respectively. There were significant differences in difficulties in emotion regulation dimensions among bullies, bullying victims and normal adolescents. Mainly, the study suggested that there are direct and indirect effects of all the dimensions of difficulties in emotion regulation on bullying.

الاسهام النسبى للمناخ المدرسى وأنماط إدارة الفصل الدراسى في التنبؤ بالتفاؤل الأکاديمى لدى معلمي المرحلة الابتدائية بالمدارس الحکومية والخاصة

هدف البحث إلى دراسة العلاقة بين التفاؤل الأکاديمى وکل من المناخ المدرسي وأنماط إدارة الفصل الدراسي لدى معلمي المرحلة الابتدائية بالمدارس الحکومية والخاصة، وکذلک الاسهام النسبى للمناخ المدرسى وأنماط إدارة الفصل الدراسى في التنبؤ بالتفاؤل الأکاديمى، بالإضافة إلى الفروق بينهم في ضوء نوع المدرسة (حکومي/ خاص) ومستوى الخبرة (منخفض/ متوسط/ مرتفع) والتفاعل بينهما، وقد قامت الباحثة بإعداد مقياسي التفاؤل الأکاديمي والمناخ المدرسي وتعريب مقياس أنماط إدارة الفصل الدراسي إعداد Djigic & Stojiljkovic (2012) والتحقق من خصائصهم السيکومترية، تم تطبيق المقاييس على عينة البحث الأساسية وعددهم (367) معلما ومعلمة بالمرحلة الابتدائية بالمدارس الحکومية والخاصة، وباستخدام تحليل التباين ذي التصميم العاملي (2×3) ومعامل ارتباط بيرسون وتحليل الانحدار، وأشارت نتائج البحث إلى أنه لا يوجد تأثير دال إحصائيا لکل من نوع المدرسة ومستوى الخبرة والتفاعل بينهما على التفاؤل الأکاديمي وأنماط إدارة الفصل الدراسي، ويوجد ارتباط موجب دال إحصائيا عند مستوى (0.01) بين أبعاد التفاؤل الأکاديمي وأبعاد المناخ المدرسي، کما يوجد ارتباط موجب دالة إحصائيا عند مستوى (0.01) بين أبعاد التفاؤل الأکاديمي والنمط التفاعلي لدى معلمي المرحلة الابتدائية بالمدارس الحکومية والخاصة، کما يمکن التنبؤ بالتفاؤل الأکاديمى من المناخ المدرسى والنمط التفاعلى. الکلمــــات المفتــــاحيــــة: التفاؤل الأکاديمي- المناخ المدرسي- أنماط إدارة الفصل الدراسي. The Relative contribution of school climate and classroom management styles in predicting academic optimism among primary school teachers in governmental and private schools Abstract The present research aimed to identify the relationship between academic optimism and school climate, classroom management styles among primary school teachers in governmental and private schools, and the possibility of prediciting academic optimism from school climate, classroom management styles, as well as differences between them according to school type (governmental / special), level of experience (low / moderate / high), and interaction between them. The researcher prepared academic optimism measure and school climate measure, and translated classroom management styles measure that was prepared by Djigic & Stojiljkovic (2012), then verified their psychometric properties. Measures were applied on main study sample which consisted of (367) male and female primary school teachers in governmental and private schools. By using ANOVA (2×3) and Person correlation coefficient and regression analysis, Ruselts showed that there are no statistically significant effect of school type, experience level or interaction between them on academic optimism and classroom management styles. In addition there is a statistically significant positive (0.01) between academic optimism dimensions and both school climate and Interactionist style of primary school teachers in governmental and private schools, and academic optimism can be predicited from school climate and Interactionist style.

Effect Of Interaction Between A Flipped Adaptive Learning Environment And Learning Types (Analytic – Comprehensive) to Develop Skills of Using Web 2.0 Application and Motivation For Teachers Pre – Service

The Current Study Tries To Explore The Interaction Between A Flipped Adaptive Learning Environment And Learning Types (Analytic – Comprehensive) To Develop Skills of Some Web (2.0) Application. The Main Study Sample Included (70(Students From Third Class of Faculty of Education, Tanta University. There Is Also A Survey Sample of (15) Students at the Same Class. Tools of The Study Were An Accumulative Test Formed of (50) Items To Measure The Cognitive Aspect of Web Skills (2.0) And An Observation Card Which Contained(5) Main Skills Divided Into (40) Subsidiary Ones. Study Results Demonstrated An Effect of The Flipped Adaptive Learning Environment on Progressing The Cognitive Achievement Aspect of Web (2.0) Application Skills Besides Realizing Effect of Interaction Between A Flipped Adaptive Learning Environment And Learning Types (Analytic – Comprehensive ) To Develop Skills of Using Web (2.0) Application And Motivation For Teachers Pre – Service At Faculty of Education , Tanta University.

Biomechanical analysis of bilateral deficit phenomenon for upper limbs in Weight training

This study aims to explain and study the phenomenon of bilateral disability of the upper end during weight training from the standpoint of biomechanics through: - Biomechanical analysis of the phenomenon of the second deficit. 1- Research Methodology The researcher used the descriptive method using the survey method to suit the nature of the study. 2- Research Simple: The main study sample was chosen by deliberate method from the players participating in Maximum Gym Club in Port Said. The sample included (4) players.

Association of Gestational Weight Gain With Adverse Maternal and Infant Outcomes

Both low and high gestational weight gain have been associated with adverse maternal and infant outcomes, but optimal gestational weight gain remains uncertain and not well defined for all prepregnancy weight ranges. To examine the association of ranges of gestational weight gain with risk of adverse maternal and infant outcomes and estimate optimal gestational weight gain ranges across prepregnancy body mass index categories. Individual participant-level meta-analysis using data from 196 670 participants within 25 cohort studies from Europe and North America (main study sample). Optimal gestational weight gain ranges were estimated for each prepregnancy body mass index (BMI) category by selecting the range of gestational weight gain that was associated with lower risk for any adverse outcome. Individual participant-level data from 3505 participants within 4 separate hospital-based cohorts were used as a validation sample. Data were collected between 1989 and 2015. The final date of follow-up was December 2015. Gestational weight gain. The main outcome termed any adverse outcome was defined as the presence of 1 or more of the following outcomes: preeclampsia, gestational hypertension, gestational diabetes, cesarean delivery, preterm birth, and small or large size for gestational age at birth. Of the 196 670 women (median age, 30.0 years [quartile 1 and 3, 27.0 and 33.0 years] and 40 937 were white) included in the main sample, 7809 (4.0%) were categorized at baseline as underweight (BMI <18.5); 133 788 (68.0%), normal weight (BMI, 18.5-24.9); 38 828 (19.7%), overweight (BMI, 25.0-29.9); 11 992 (6.1%), obesity grade 1 (BMI, 30.0-34.9); 3284 (1.7%), obesity grade 2 (BMI, 35.0-39.9); and 969 (0.5%), obesity grade 3 (BMI, ≥40.0). Overall, any adverse outcome occurred in 37.2% (n = 73 161) of women, ranging from 34.7% (2706 of 7809) among women categorized as underweight to 61.1% (592 of 969) among women categorized as obesity grade 3. Optimal gestational weight gain ranges were 14.0 kg to less than 16.0 kg for women categorized as underweight; 10.0 kg to less than 18.0 kg for normal weight; 2.0 kg to less than 16.0 kg for overweight; 2.0 kg to less than 6.0 kg for obesity grade 1; weight loss or gain of 0 kg to less than 4.0 kg for obesity grade 2; and weight gain of 0 kg to less than 6.0 kg for obesity grade 3. These gestational weight gain ranges were associated with low to moderate discrimination between those with and those without adverse outcomes (range for area under the receiver operating characteristic curve, 0.55-0.76). Results for discriminative performance in the validation sample were similar to the corresponding results in the main study sample (range for area under the receiver operating characteristic curve, 0.51-0.79). In this meta-analysis of pooled individual participant data from 25 cohort studies, the risk for adverse maternal and infant outcomes varied by gestational weight gain and across the range of prepregnancy weights. The estimates of optimal gestational weight gain may inform prenatal counseling; however, the optimal gestational weight gain ranges had limited predictive value for the outcomes assessed.

Influence Of Strategy Implementation On The Performance Of Maritime Cluster Firms In Kenya

The study of strategy implementation on the performance of maritime cluster firms has not been fully exhausted for economic growth despite its vast potential resources. In recent times, many countries near the oceans, seas, lakes, rivers and dams are exploiting their natural resources both off shore and on shore (for blue economy) with an aim of increasing their competitive advantage to create employment opportunities, wealth as new frontier by implementing maritime clusters strategy for economic growth and sustainability. This process helps them strengthen their national and regional competitiveness through clustering for their industrial development through processing, manufacturing and value addition of their products. This study seeks to stir up an academic curiosity in the field of maritime academic discipline and anticipates enhancing both policy and knowledge gaps in maritime related cluster firms. The findings of the research will be of importance to policy makers within the government and the maritime cluster firms as well as contribute to the body of knowledge as a reference material for future research works. The main objective of this study is to establish the influence of strategy implementation on performance of Maritime Cluster firms in Kenya and the specific objectives of this study are to establish the influence of strategic policies, strategic direction, organization structure, resource capability, technology innovation, firms’ size and years of operation on the performance of maritime cluster firms in Kenya. The research will allow collection of both quantitative and qualitative data and adopt descriptive research (statistical research) as well as inferential statistics designs in which variables of interest will not be controlled or manipulated. The target population of the study is 1386 maritime firms and the sample size of 94 firms which will be randomly selected as a basis for unit of analysis. Thus, the study will perform a pilot test to support reliability and validity tests based on 10% of the sample size of about 10 firms out of 94 firms which will not be included in the main study sample. Both primary and secondary data will be collected by use of questionnaires, structured interviews as instrument of data collection. Both factor analysis and correlation analysis will be used to determine the magnitude and direction of the association between research variables. The study will further perform hypothesis testing using ANOVA. The quantitative data collected will be analysed further through descriptive statistics such as mean, median, standard deviation supported by the statistical package for social science SPSS version 22 whereas the qualitative data will be analysed by use thematic analysis.

Efficacy of a new parent and school-supported intervention after moderate and severe childhood traumatic brain injury.

Traumatic brain injury is a common cause of acquired disability during childhood. Early interventions focusing on parenting practices may prove effective at reducing negative child outcomes. To determine the efficacy of a new counselling program aimed at parents and schools compared to a control group. The main study sample was obtained from a paediatric hospital. The final sample consisted of 42 children aged between 6 and 16 years old. Comparing with normative data, pre-post comparisons between groups showed a significant improvement in the parent group with respect to the control group. The superiority of the parental intervention group over those of the control group was not only statistically significant, but also clinically substantial and meaningful. The results of this study suggest that children with moderate to severe traumatic brain injury can benefit from an intensive supported family treatment.

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Obstacles of Saudi Woman Work in the Mixed Environment: A Field Study

The study aimed to identify the obstacles facing Saudi woman while working in a mixed work environment. The main study sample consisted of (223) from the health sector female affiliates and were divided into two groups. The first group consisted of (129) participants from the health sector and workers in Riyadh, Kingdom of Saudi Arabia (KSA) hospitals. The second group involved (94) participants from the health sector and workers in Najran, KSA hospitals. The study adopted the descriptive and analytical approach and the study instrument consisted of a questionnaire to identify the obstacles that the Saudi women encounter in the mixed environment. Results indicated that the most serious obstacles that Saudi woman encounters in the mixed work environment were social, professional, ethical, and psychological obstacles. There were statistically significant differences between the mean scores of women working in Riyadh and those women who working Najran regarding to the social obstacles in favor of women working in Najran and the ethical obstacles in favor of women working in Riyadh. There were no statistically significant differences between both groups in accordance to psychological and professional obstacles and the overall questionnaire degree. Furthermore, there were significant differences due to the nature of the work, whether a physician, nurse, or administrative employee regarding the social obstacles in favor of the woman working the administration field. There were significant differences with regard to both ethical and psychological obstacles in favor of women working in the administration field.