Quantitative Study Research Articles

Quantitative study on the relationship between land use and land cover and diatom community in urban streams.

The study of the impact of urbanization on river ecosystems is an important part of constructing sustainable cities. How to quantitatively study the impact of urbanization on river ecosystems is the difficulty of urban ecological research. This study quantitatively investigated the effects of LULC on water quality and diatom assemblages in urban streams by correlation analysis, multivariate analysis, and path analysis. The results showed that (1) the percentage of LULC type in buffer 600m of reference stream sites is significantly different from that of urban stream sites. In reference sites, the average percentage of green was 94.2%, barren 3.3%, and impervious surface 2.5%. In urban upstream sites, the average percentage of impervious surface was 63.1%, green 32.8%, water 3.3%, and barren 0.8%. In urban downstream, the average percentage of impervious surface was 59.0%, green 36.5%, water 2.7%, and barren 1.8%. (2) One-way analysis results showed that water quality variables were significantly differences among the sites. The correlation analysis results indicated that LULC had a significant influence on water quality. Green had a significant negative correlation with high concentrations of NO3-N, NH4-N, and Cond. but positively correlated with MSUBST. RDA results showed that the selected water quality variables, MSUBST, and LULC types have a significant impact on the spatial patterns of the diatom assemblages. (3) Path analysis results showed that both LULC types and water quality variables exerted significant effects on diatom assemblages. This study first clarifies the quantitative relationships among LULC types, water quality, and diatom assemblages in the Beijing area. And green land was positively correlated with water quality and river ecosystems. We believed that increasing green space in urban core areas is an effective measure for improving water quality and restoring river ecosystems in the urban area.

Customer-based brand competitiveness (CBBC) scale: advancing the relative perspective

Purpose Brand competitiveness as a brand’s outperformance of competing brands is receiving growing attention in the literature. This study aims to provide a theoretical underpinning for the construct’s relevance, introduce customer-based brand competitiveness (CBBC) as a customer-based perspective and develop a scale to measure the construct. Design/methodology/approach The scale development process comprises three stages, with a literature search and a qualitative consumer study (n = 20) in the scale construction stage, interviews and a survey with academic branding experts (n = 21) in the scale refinement stage and three quantitative studies with consumers (n = 1,157), resulting in 2,078 brand evaluations across five industries, in the scale validation stage. Findings This study develops a seven-item CBBC scale, representing a powerful yet parsimonious tool for measuring brand competitiveness. The superiority of the new over the existing brand competitiveness scale was validated through structural equation modelling by comparing the performance in explaining customer-based brand equity and purchase intentions. Originality/value To the best of the authors’ knowledge, this study is the first to develop a brand competitiveness scale following a scholarly scale development process. The CBBC scale advances the relative perspective in brand performance measures, considering the relativity at the individual customer level. This study offers a theoretical underpinning for the construct’s relevance and further insights into brand competitiveness by investigating the customer-based perspective. Finally, this study suggests and empirically validates customer-based brand equity and purchase intentions as outcomes of CBBC, extending research into the nomological network of brand competitiveness.

Preferences of melanoma patients to accept adjuvant therapy and toxicity – a qualitative substudy of the GerMelaTox-A project

PurposeTargeted treatment and immunotherapy, both adjuvant treatment options, come with a certain toxicity and can cause severe side effects. To date, data about the underlying reasons for patients to accept or reject specific types of adjuvant therapy is scarce. Therefore, this study investigates the motives of melanoma patients for tolerating or rejecting adjuvant therapy and its side effects.MethodsWe conducted semi-structured interviews with a subsample of patients to investigate the underlying reasons for treatment decisions in a quantitative treatment-trade off study. Categorisation was conducted using qualitative content analysis.ResultsThe 17 participants had a mean age of 55.5 years and 12 were female. The final category system covered three clusters. The cluster “type of therapy and therapy process” described therapy-related aspects that affect acceptability of adjuvant treatments. Prospect of treatment benefit and side effects were important aspects. Route of administration and physician visits should be convenient. The cluster “way of living” described the influence that activities and circumstances of life organisation have on acceptability. Participants wished treatment to affect everyday life as little as possible. Maintaining sufficient quality of life was mentioned to be crucial. The cluster “emotions and feelings” described optimism and hope but also mental strain originating from possible treatment options.ConclusionPatients in our study indicate high willingness to undergo adjuvant therapy, even when facing toxicity. The evaluation of potential side effects and prospects of treatment benefit is highly individual. Therefore, it is important to consider personal patient preferences to make appropriate and shared decision-making.

The well-being of software engineers: a systematic literature review and a theory

For decades, software engineering research and practice has focused primarily on technological and process-related factors. Today, there is a growing interest in organizational, social, and psychological factors, including well-being. Organizational studies show that well-being contributes to work outcomes, including creativity, performance, and productivity. But despite its importance, the predictors and outcomes of software engineers’ well-being as a multidimensional construct to date are under-researched. This paper reports on the multidimensional well-being of professional software engineers and generates insights for the future research in this area. 44 quantitative survey studies published between 2000 and 2023 were selected and synthesized both quantitatively and qualitatively through a systematic literature review. The results of the review were further analyzed to construct a quantitatively-testable theory, detailing the predictors and outcomes of well-being in software engineering organizations. The total number of research participants included in the selected studies is 16,086 software engineering professionals from at least 42 countries. The literature review identified various measures, constructs, and indicators of well-being, as well as its predictors and outcomes. The theory, based on cumulative results of carefully selected quantitative studies, is an attempt to “correct the record” by establishing well-being in software engineering as a meta-construct of hedonic, eudaimonic, and integrated or hedaimonic qualities predicted by different individual, team and organizational factors and impacting the functioning of software engineers and their organizations. The review highlighted the under-researched aspects of well-being in software engineering and confirmed the need for more advanced quantitative studies. We hope that the theory will benefit researchers in conducting future studies and practitioners in developing nuanced and science-based interventions for improving software engineers’ well-being.

Effectiveness and Acceptability of Asynchronous Digital Health in Asthma Care: Mixed Methods Systematic Review.

Asynchronous digital health (eg, web-based portal, text, and email communication) can overcome practical barriers associated with in-person and remote synchronous (real-time) consultations. However, little is known about the effectiveness and acceptability of asynchronous digital health to support care for individuals with asthma (eg, asthma reviews). We aimed to systematically review the qualitative and quantitative evidence on the role of asynchronous digital health for asthma care. Following Cochrane methodology, we searched 6 databases (January 2001-July 2022; search update: September 2023) for quantitative, qualitative, or mixed methods studies supporting asthma care using asynchronous digital health. Screening and data extraction were duplicated. We assessed the risk of bias in the clinical outcomes of randomized controlled trials included in the meta-analysis using the revised Cochrane risk of bias tool. For the remaining studies, we evaluated the methodological quality using the Downs and Black checklist, critical appraisal skills program, and mixed methods appraisal tool for quantitative, qualitative, and mixed methods studies, respectively. We determined the confidence in the evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) criteria. We conducted a meta-analysis of trial data and a thematic analysis of qualitative data. We included 30 studies (20 quantitative, 6 qualitative, and 4 mixed methods) conducted in 9 countries involving individuals with asthma, their caregivers, and health care professionals. Asynchronous digital consultations linked with other functionalities, compared to usual care, improved asthma control (standardized mean difference 0.32, 95% CI 0.02-0.63; P=.04) and reduced hospitalizations (risk ratio 0.36; 95% CI 0.14-0.94; P=.04). However, there were no significant differences in quality of life (standardized mean difference 0.16; 95% CI -0.12 to 0.43; P=.26) or emergency department visits (risk ratio 0.83; 95% CI 0.33-2.09; P=.69). Patients appreciated the convenience of asynchronous digital health, though health care professionals expressed concerns. Successful implementation necessitated an organizational approach. Integrative synthesis underscored the ease of asking questions, monitoring logs, and medication reminders as key digital functionalities. Despite low confidence in evidence, asynchronous consultation supported by digital functionalities is an effective and convenient option for nonemergency asthma care. This type of consultation, well accepted by individuals with asthma and their caregivers, offers opportunities for those facing challenges with traditional synchronous consultations due to lifestyle or geographic constraints. However, efficient organizational strategies are needed to manage the associated workload. PROSPERO CRD42022344224; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=344224. RR2-10.1371/journal.pone.0281538.

The influencing factors of newly employed nurses’ adaptation in Malaysia: a structural equation modelling assessment

BackgroundGraduate nurses commonly experience the transition phase and are required to adapt quickly to their new workplace, as it is a prerequisite for a successful transition. However, workplace adaptation is extremely challenging and may affect nurses’ future career prospects if not managed properly. Therefore, we aimed to determine the factors that facilitate newly employed nurses’ adaptation and integration at Ministry of Health (MOH)-run state hospitals in Malaysia. The study framework was derived and adapted from the Roy adaptation model and organisational socialisation theories.MethodsThis quantitative study was conducted from May 2021 to December 2021. The sample population was newly employed nurses working at state hospitals with 1–2 years of service experience. This study involved 496 newly hired nurses from MOH state hospitals. Questionnaires were distributed through Google Forms. The data were analysed using covariance-based structural equation modelling.ResultsThe participants perceived that workplace organisation (OC), academic institution contribution (AIC), and new nurse’s personality traits (PT) contributed approximately 36% to newly employed nurses’ adaptation (NENA). PT partially mediated the relationship between OC and NENA and between AIC and NENA.ConclusionsThe results could be useful to nursing authorities. We also recommend that a nurse’s personality be developed, emphasised, and enhanced through continuous programmes or training to ensure that they can easily adapt to their new working environment. Furthermore, academic institution and work organisation collaboration should be encouraged to develop improvement cycles that facilitate newly employed nurses’ prompt and efficient adaptation at MOH hospitals during transition.

The Role of Smartwatch Technology in the Provision of Care for Type 1 or 2 Diabetes Mellitus or Gestational Diabetes: Systematic Review

Abstract Background The use of smart technology in the management of all forms of diabetes mellitus has grown significantly in the past 10 years. Technologies such as the smartwatch have been proposed as a method of assisting in the monitoring of blood glucose levels as well as other alert prompts such as medication adherence and daily physical activity targets. These important outcomes reach across all forms of diabetes and have the potential to increase compliance of self-monitoring with the aim of improving long-term outcomes such as hemoglobin A1c (HbA1c). Objective This systematic review aims to explore the literature for evidence of smartwatch technology in type 1, 2, and gestational diabetes. Methods A systematic review was undertaken by searching Ovid MEDLINE and CINAHL databases. A second search using all identified keywords and index terms was performed on Ovid MEDLINE (January 1966 to August 2023), Embase (January 1980 to August 2023), Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library, latest issue), CINAHL (from 1982), IEEE Xplore, ACM Digital Libraries, and Web of Science databases. Type 1, type 2, and gestational diabetes were eligible for inclusion. Quantitative studies such as prospective cohort or randomized clinical trials that explored the feasibility, usability, or effect of smartwatch technology in people with diabetes were eligible. Outcomes of interest were changes in blood glucose or HbA1c, physical activity levels, medication adherence, and feasibility or usability scores. Results Of the 8558 titles and abstracts screened, 5 studies were included for qualitative synthesis in this review. A total of 322 participants with either type 1 or type 2 diabetes mellitus were included in the review. A total of 4 studies focused on the feasibility and usability of smartwatch technology in diabetes management. One study conducted a proof-of-concept randomized clinical trial including smartwatch technology for exercise time prescriptions for participants with type 2 diabetes mellitus. Adherence of participants to smartwatch technology varied between included studies, with one reporting input submissions of 58% and another reporting that participants logged 50% more entries than they were required to. One study reported significantly improved glycemic control with integrated smartwatch technology, with increased exercise prescriptions; however, this study was not powered and required a longer observational period. Conclusions This systematic review has highlighted the lack of robust randomized clinical trials that explore the efficacy of smartwatch technology in the management of patients with type 1, type 2, and gestational diabetes. Further research is required to establish the role of integrated smartwatch technology in important outcomes such as glycemic control, exercise participation, drug adherence, and diet monitoring in people with all forms of diabetes mellitus.

Relationship Between Anxiety and Fomo (Fear of Missing Out) With Nomophobia In Nursing Faculty Students

Introduction: Smartphones can have positive and negative impacts on their users. Generally, smartphone use among the community is difficult to control, causing dependence on smartphone use or known as nomophobia. Objective: This study aims to determine the relationship between anxiety and FoMO in the Faculty of Nursing, University of Riau. Method: This study is a quantitative study using a descriptive correlational design and a cross-sectional approach. The research sample was 235 respondents from the Faculty of Nursing, University of Riau using the stratified random sampling technique. The instruments used in this study were the No Mobile Phone Phobia Questionnaire (NMP-Q), Fear of Missing Out Scale (FoMOS) and HARS (Hamilton Anxiety Rating Scale). The analysis using the alternative kolmogorov smirnov test. Results: The majority of respondents experienced moderate nomophobia as many as 129 (54.9%), high anxiety as many as 121 (51.5%) and high FoMO as many as 123 (52.3%) students. There was a significant relationship between anxiety and nomophobia with a p value = 0.001 <0.05 and there was a significant relationship between FoMO and nomophobia obtained a p value = 0.000 <0.05. Conclusion: The higher the anxiety and FoMO, the higher the nomophobia, conversely, the lower the anxiety and FoMO, the lower the nomophobia in students.

Cultural Competence and Nursing Work Environment: Impact on Culturally Congruent Care in Portuguese Multicultural Healthcare Units

Background: Cultural competence is central to ensuring effective culturally congruent care to patients and fostering positive work environments, particularly in multicultural settings. Objective: This study aimed to analyse the relationship between cultural competence, the nursing work environment, and the delivery of culturally congruent care in multicultural units of a healthcare organisation in Portugal. Method: This was a quantitative, descriptive, and cross-sectional study, targeting nurses from multicultural units. Data were collected using both online and paper-based questionnaires, which included the Cultural Competence Questionnaire for Help Professionals, the Nursing Work Index—Revised Scale (NWI-R-PT), and a single question assessing nurses’ perceptions of the adequacy of the culturally congruent care they provide. Results: A moderate, positive correlation was identified between cultural competence and the Fundamentals for Nursing, while the nursing work environment was influenced by organisational support, professional category, and unit type. Discussion: The findings suggest that enhancing cultural knowledge and technical skills and reinforcing management support may positively impact culturally congruent care delivery in multicultural settings. Conclusion: This study contributes to nursing knowledge by highlighting the complex interactions between cultural competence and the work environment in Portuguese multicultural healthcare units. Future research should explore the impact of transcultural nursing leadership on multicultural work environments and in the delivery of culturally congruent care.

CONHECIMENTO DOS ALUNOS DO CURSO DE PEDAGOGIA SOBRE NOÇÕES BÁSICAS DE PRIMEIROS SOCORROS

Introduction: In the school environment, many accidents can happen to a child, and many situations can lead to death if first aid is not properly applied. Training educators in first aid is important to prevent and reduce this rate. In addition to including the course in the pedagogy curriculum, the study sought to assess the knowledge of pedagogy students related to the basic notions of first aid. This is an exploratory-descriptive, quantitative and cross-sectional action research study conducted at the Campo Limpo Paulista University Center (UNIFACCAMP), located in the city of Campo Limpo Paulista, in the state of São Paulo. The questionnaires prepared by the researchers were used as data collection tools. They included data for sociodemographic characterization, eight questions about first aid in situations of sprain, dislocation/fracture, contusion, syncope, convulsion and choking (airway obstruction by a foreign body) and one question focused on the Lucas Law and another on the importance of implementing first aid in the curriculum of the pedagogy course, obtaining descriptive and quantitative data. The questionnaire was applied before and after the intervention of the health action and consisted of a practical demonstration and explanation of the procedures in situations of sprain, dislocation/fracture, contusion, syncope, convulsion and choking, distribution of the folder with illustrations in images and informative text about the first aid maneuvers. The sample consisted of 33 regular students of the pedagogy course. At the end of the meeting, a positive effect was observed in relation to the expansion of knowledge about the practices that can be adopted in situations that require first aid care. Thus, this study demonstrated and reinforced the importance of first aid from the undergraduate period, thus contributing to the protection of life, both in the school environment and in everyday situations.

Few-to-many-particle crossover of pair excitations in a superfluid

Motivated by recent advances in the creation of few-body atomic Fermi gases with attractive interactions, we study theoretically the few-to-many-particle crossover of pair excitations, which for large particle numbers evolve into a mode that describes amplitude fluctuations of the superfluid order parameter (the “Higgs” mode). Our analysis is based on the hypothesis that salient aspects of the excitation spectrum are captured by interactions between time-reversed pair states in a harmonic oscillator potential. Microscopically, this assumption leads to a Richardson-type pairing model, which is integrable and thus allows a systematic quantitative study of the few-to-many-particle crossover with only minor numerical effort. We first establish a parity effect in the ground-state energy, i.e., a spectral convexity in the energy of open-shell configurations compared to their closed-shell neighbors, which is quantified by a so-called Matveev-Larkin parameter discussed for mesoscopic superconductors, which generalizes the pairing gap to mesoscopic ensembles and which behaves quantitatively differently in a few-body and a many-body regime. The crossover point for this quantity is widely tunable as a function of interaction strength. We then compute the excitation spectrum and demonstrate that the pair excitation energy shows a minimum that deepens with increasing particle number and shifts to smaller interaction strengths, consistent with the finite-size precursor of a quantum phase transition to a superfluid state. We extract a critical finite-size scaling exponent that characterizes the decrease of the gap with increasing particle number. Published by the American Physical Society 2024

Systematic Review of 3D-Printed Ultrasound-able Models in Graduate Medical Education.

This systematic review aimed to identify studies that have created ultrasound-able models for resident procedural training by means of 3D-printing techniques and examine their tissue specific properties. There were 456 articles identified from 3 databases, of which, 35 studies were assessed for eligibility, and 11 total studies were included. All qualitative studies showed improvements in procedural skills and 89% of the quantitative studies showed significant results. Studies that documented modeling price showed a 90% reduction in fabrication cost compared to commercial models. Three-dimensional-printed, ultrasound-able models have the potential to provide trainees with low-cost, high-fidelity training opportunities.

A Comparative Study of Learning Modalities and Academic Performance in a Private Senior High School in Southern Philippines

This quantitative study aimed to identify the level of academic performance among senior high school students in terms of synchronous, asynchronous, and modular learning modalities. Furthermore, the study aimed to determine if there is a significant difference in academic performance as analyzed according to types of learning modalities. Descriptive-comparative was utilized to answer the research questions with 362 respondents under the Science, Technology, Engineering, and Mathematics strand. The findings showed that students under synchronous got a higher mean with outstanding descriptive equivalent, and students under asynchronous and modular got a very satisfactory descriptive equivalent. The result implied that students who chose synchronous classes gained higher grades than those who chose the other two learning modalities. This further indicates that synchronous classes have effectively delivered lessons and led to students’ higher academic performance. Modular to Asynchronous and Modular to Synchronous have .000 significant differences, and Asynchronous to Synchronous has 0.006. This result implied a significant difference among the types of learning modalities. Regarding participant’s personal information, sex, and parental support, they had no significant moderating effects on their academic performance as analyzed according to types of learning modalities. In contrast, school support had significant moderating effects on academic performance as analyzed according to types of learning modalities. Hence, this study recommended that the school continue offering online classes and strategize plans for modular students for a better educational outcome.

Screen Time and Autism Spectrum Disorder: A Comprehensive Systematic Review of Risk, Usage, and Addiction.

The relationship between autism spectrum disorder (ASD) and screen time (ST) has been extensively studied; but the evidence remains inconsistent, and a comprehensive quantitative synthesis of this association is lacking. This study aims to provide a robust quantitative assessment of the relationship between ASD and ST by consolidating and analyzing available evidence to offer a more precise understanding of this complex association. This systematic review followed PRISMA 2020 statement, and applied a quality assessment tool for quantitative studies to identity best available evidence. A comprehensive search was conducted in PubMed, Web of Science, Embase, and Scopus, covering literature published from January 1, 2006 to June 12, 2024. In total, 30 studies involving 356,666 participants met the inclusion criteria. The findings revealed a significant association between screen exposure in preschool children and the development of ASD, with a longer duration of screen exposure correlating with an increased likelihood of being diagnosed with autism. Furthermore, autistic people tend to have longer daily screen use and are at a higher risk of screen addiction compared to non-autistic individuals. These findings emphasize the importance of limiting ST for preschoolers and autistic people. However, the level of evidence supporting these conclusions is very low. Future studies should focus on controlling for confounding factors, using more objective measures, and further investigate the relationship between screen engagement styles (active or passive), screen use patterns (screen devices and content), and ASD.

Pro-life, Pro-Choice and everything in between: A quantitative study of popular attitudes on abortion in the Faroe Islands

Having debated the rights of sexual minorities for two decades, the question of abortion is increasingly emerging as a new fault line in Faroese politics. In spring of 2024, the Faroese Parliament rejected the legalisation of free abortion by the slimmest margin possible, and civil society NGOs are spearheading “pro-choice” and “pro-life” campaigns. But how does the Faroese voter relate to the question? Who supports and who opposes the legalisation of free abortion before week twelve? On the basis of a quantitative survey conducted in November 2022, this article examines public opinion on abortion legislation and what demographic and personal factors predict abortion attitudes. While it is not possible to present conclusive evidence on the basis of one single study, the findings indicate that the Faroese public is divided on the issue. Furthermore, there is a positive correlation between pro-life attitudes and the importance of religion as well as right-wing attitudes, while centre-periphery tensions are also visible. However, and in contrast with international surveys in the cross-national literature on abortion and public opinion, the survey finds no difference between men and women, and educational level does not predict abortion attitudes either. Finally, when examining the role of age, the generation between 30-44 years proves most likely to oppose the legalisation of abortion on demand. Úrtak Eftir at hava kjakast um rættindi hjá seksuellum minnilutum í tvey áratíggju er ósemjan um abort ella fosturtøku vorðin alsamt sjónligari í føroyskum politikki. Á vári í 2024 atkvøddi ein tepur meiriluti ímóti nýggjari lóg, sum loyvir fríari fosturtøku, samstundis sum felagsskapir stríðast bæði fyri og ímóti rættinum til abort. Men hvat hugsar føroyski veljarin um hendan spurning? Hvør er fyri og hvør er ímóti fríari abort áðrenn 12. viku? Við støði í kvantitativari kanning frá november 2022 kannar hendan greinin almennan hugburð til abort og hvørji demografisk og persónlig viðurskifti mynda hugburð til hendan spurning. Uttan at draga ov greiðar niðurstøður við støði í einstøkum kanningum geva úrslitini ábendingar um, at føroyskir veljarar eru sera ósamdir. Hagfrøðiliga finst ein signifikantur samanhangur millum átrúnað, høgravendan hugburð og mótstøðu ímóti fríari abort, samstundis sum munirnir millum miðstaðarøkið og økini kring landið eisini eru sjónligir. Men í andsøgn til gransking aðrastaðni finst eingin signifikantur munur á monnum og kvinnum, og útbúgving hevur heldur ongan týdning. Viðvíkjandi aldri er aldursbólkurin millum 30 og 44 ár í størri mun ímóti fríari abort samanborið við aðrar aldursbólkar.

Anxiety and Depression Disorders in Undergraduate Medical Students During the COVID-19 Pandemic: An Integrative Literature Review

Introduction: The COVID-19 pandemic has triggered several challenges on the front of mental health. Undergraduate medical students face considerable stress in their academic routines. Thus, there is a need to explore the implications for the mental health of undergraduate medical students during the COVID-19 pandemic. Objective: To review the global literature about anxiety and depressive disorders in undergraduate medical students during the COVID-19 pandemic. Method: We developed an integrative literature review on the occurrence of anxiety and depressive symptoms in undergraduate medical students during the COVID-19 pandemic. We included the manuscripts that used the PHQ-9 and/or GAD-7 questionnaires. We excluded systematic reviews, narrative reviews, integrative reviews, meta-analyses, and qualitative analytical studies. We assessed the results on the occurrence of anxiety and depression and the severity of symptoms in medical students during the COVID-19 pandemic using quantitative studies applying the GAD-7 questionnaire for anxiety or the PHQ-9 for depression. Results: We reviewed 85 selected studies, and the results showed a significant prevalence of moderate and severe symptoms of anxiety and depression, with 28.2% of participants presenting scores of ≥ 10 on the GAD-7 and 38.9% on the PHQ-9. Statistical analyses using simple and multiple regression tests revealed associations between higher rates of anxiety symptoms among students from developing countries and data collected after the lockdown period in 2020 during the pandemic lockdown. In addition, female students were at risk of depressive disorders. We emphasize as a limitation that the diagnosis of depression and anxiety requires a detailed clinical evaluation, which is not focused on in this actual study. Conclusions: Our findings highlight the need for specific interventions to support the mental health of undergraduate medical students, especially female students from developing countries, during a pandemic crisis.

Tourism Policymaking in Troubling Times: Sustainability-Driven Challenges, Implemented Policies, and Goals for Sustainable Development

Tourism’s vulnerability to crises underscores the need for new or adapted tourism policies that prioritize sustainable tourism development across ecological, economic, and stakeholder dimensions. While past research has highlighted the relevance of sustainable policies for tourism crisis recovery, the research gap lies in the actual implementation of these policies in response to crises. This study examines tourism policymaking in Europe by conducting a quantitative study with 181 tourism organizations responsible for sustainable tourism and its policy implementation. Exploratory factor analysis and structural equation modeling were employed to reveal how tourism policymakers perceive challenges, the subsequent impact on implemented policies, and the intended sustainability-driven goals. Specifically, policies addressing environmental, technological, promotional, and personnel challenges have been enacted due to the climate change crisis, the COVID-19 pandemic, and financial recessions. These policies not only aim to pursue economic recovery but also contribute to the sustainable development of tourism, engaging key stakeholders and aligning with broader sustainability goals such as climate action and governance. This study addresses the underdeveloped area of sustainomics by contributing to the discourse on political implementation for sustainable development, providing a critical exploration of how tourism governance can enhance sustainability practices in crisis contexts.

Pengaruh Kualitas Makanan, Kualitas Layanan dan Harga Terhadap Loyalitas Pelanggan dengan Kepuasan Pelanggan Sebagai Mediasi

The development of the restaurant business is currently very rapid, especially with the emergence of various new businesses with various concepts. In the face of intense competition, restaurants need to understand their weaknesses and develop the right operational strategies and marketing policies to increase customer satisfaction. This study aims to fill the knowledge gap about the role of customer satisfaction on customer loyalty, food quality, service quality and price. The population in this study consisted of Solaria customers in the Tangerang area. While the research sample was taken using purposive sampling technique with a total of 205 respondents. This research is a quantitative study that uses the Structural Equation Model - Partial Least Square (SEM-PLS) method. The results showed that food quality and price positively affect customer loyalty either directly or indirectly through customer satisfaction. Furthermore, service quality has a direct positive effect on customer satisfaction and customer loyalty. Then, customer satisfaction positively affects customer loyalty. And customer satisfaction is not proven to mediate the relationship between service quality and customer loyalty. After conducting research, the author suggests expanding the population of respondents from various regions so that researchers can compare the results between customer areas from various regions.

Challenges in the Implementation of Technology in effective Hospital Management System: A quantitative study

To provide excellent care to patients and to maintain seamless functioning of healthcare facilities it is crucial to have effective hospital management system. Hospital management system presently is incorporating analytical approach to optimize work flow, for enhancement of resource utilization, and for providing comprehensive insurance assistance to patients. The technologies are highly crucial for workflow optimization, allocation of resources, scheduling of patients, and management of finances. There are various challenges faced by hospital management system like integration of data from diversified sources like billing system, administrative database, EHRs, and data accuracy and consistency. Safeguarding of data security is highly important that need strong security and adhering to rules and regulation as per the “Health Insurance Portability and Accountability Act.” The importance of Information Technology is reducing rising costs of healthcare and improving quality of services. There is a need to address such challenges and identify the best way of technology implementation. A sample of 249 was collected from different departments in Hospital. The factors that identify the Challenges in the Implementation of Technology in effective Hospital Management System are High Initial Costs, Resistance to Change, Training and Skill Development, and Regulatory and Compliance Challenges.

Pengaruh Locus of Control, Self Efficacy dan Employee Engagement Terhadap Kinerja Karyawan pada Objek Wisata Owabong Water Park Purbalingga

The aim of this study is to examine the influence of locus of control, self efficacy and employee engagement on employee performance at the tourist attraction of Owabong Water Park Purbalingga. The study is a quantitative study using a total of 112 respondents of permanent employees at owabong water park purbalingga. The simple sampling technique used is the method of saturated samples. The analysis technique used in this study is using the SPSS Version 26 tool. The tests used in this study include the Validity Test, Reliability Test, Normality Test, Multicolinearity test, Heteroscadastisity Tests, Dual Linear Regression Analysis Tests and F and T Tests. The results of this study show that locus of control has a positive and significant impact on employee performance, self efficacy has a significant and positive impact on the employee's performance, employee engagement has a partial and significant effect on employees' performance, and locus Of Control, Self Efficiency and Employee Engagement simultaneously have a positive effect on Employees' performance. The practical implications of this study are the need for companies to focus on developing strategies and programmes that can increase employee engagement levels, thereby improving employee overall performance.