Student satisfaction and academic efficacy during online learning with the mediating effect of student engagement: A multi-country study.

The COVID-19 pandemic caused unprecedented changes to educational institutions, forcing their closure and a subsequent shift to online education to cater to student learning requirements. However, successful online learning depends on several factors and may also vary between countries. As such, this cross-sectional study sought to investigate how engagement of university students, a major driver of online learning, was influenced by course content, online interaction, student acceptance, and satisfaction with online learning, as well as self-efficacy across nine countries (China, India, Iran, Italy, Malaysia, Portugal, Serbia, Turkey, and the United Arab Emirates) during the COVID-19 pandemic. Using a questionnaire-based approach, data collected from 6,489 university students showed that student engagement was strongly linked to perception of the quality of the course content and online interactions (p < .001). The current study also indicated that online interactions are a major determinant of academic efficacy but only if mediated by engagement within the online learning context. A negative correlation between student engagement and satisfaction with online learning was found, demonstrating the importance of students being engaged behaviorally, emotionally, and cognitively to feel satisfied with learning. Academic efficacy and student satisfaction were explained by course content, online interaction, and online learning acceptance, being mediated by student engagement. Student satisfaction and, to a lesser degree academic efficacy, were also associated with online learning acceptance. Overall, the structural equation model was a good fit for the data collected from all nine countries (CFI = .947, TLI = .943; RMSEA = .068; SRMR = .048), despite differences in the percentage variations explained by each factor (no invariance), likely due to differences in levels of technology use, learning management systems, and the preparedness of teachers to migrate to full online instruction. Despite limitations, the results of this study highlight the most important factors affecting online learning, providing insight into potential approaches for improving student experiences in online learning environments

Cognitive behavioural therapy (CBT) for adults and adolescents with asthma.

BACKGROUND: People with asthma have a higher prevalence of anxiety and depression than the general population. This is associated with poorer asthma control, medication adherence, and health outcomes. Cognitive behavioural therapy (CBT) may be a way to improve the quality of life of people with asthma by addressing associated psychological issues, which may lead to a lower risk of exacerbations and better asthma control. OBJECTIVES: To assess the efficacy of CBT for asthma compared with usual care. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also searched reference lists of all primary studies and review articles and contacted authors for unpublished data. The most recent searches were conducted in August 2016. SELECTION CRITERIA: We included parallel randomised controlled trials (RCTs) comparing any cognitive behavioural intervention to usual care or no intervention. We included studies of adults or adolescents with asthma, with or without comorbid anxiety or depression. We included studies reported as full text, those published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS: Two or more review authors independently screened the search results, extracted data, and assessed included studies for risk of bias. We analysed dichotomous data as odds ratios (ORs) and continuous data as mean differences (MDs) or standardised mean differences (SMD) where scales varied across studies, all using a random-effects model. The primary outcomes were asthma-related quality of life and exacerbations requiring at least a course of oral steroids. We rated all outcomes using GRADE and presented our confidence in the results in a 'Summary of findings' table. MAIN RESULTS: We included nine RCTs involving 407 adults with asthma in this review; no studies included adolescents under 18. Study size ranged from 10 to 94 (median 40), and mean age ranged from 39 to 53. Study populations generally had persistent asthma, but severity and diagnostic measures varied. Three studies recruited participants with psychological symptomatology, although with different criteria. Interventions ranged from 4 to 15 sessions, and primary measurements were taken at a mean of 3 months (range 1.2 to 12 months).Participants given CBT had improved scores on the Asthma Quality of Life Questionnaire (AQLQ) (MD 0.55, 95% confidence interval (CI) 0.17 to 0.93; participants = 214; studies = 6; I(2) = 53%) and on measures of asthma control (SMD -0.98, 95% CI -1.76 to -0.20; participants = 95; studies = 3; I(2) = 68%) compared to people getting usual care. The AQLQ effect appeared to be sustained up to a year after treatment, but due to its low quality this evidence must be interpreted with caution. As asthma exacerbations requiring at least a course of oral steroids were not consistently reported, we could not perform a meta-analysis.Anxiety scores were difficult to pool but showed a benefit of CBT compared with usual care (SMD -0.38, 95% CI -0.73 to -0.03), although this depended on the analysis used. The confidence intervals for the effect on depression scales included no difference between CBT and usual care when measured as change from baseline (SMD -0.33, 95% CI -0.70 to 0.05) or endpoint scores (SMD -0.41, 95% CI -0.87 to 0.05); the same was true for medication adherence (MD -1.40, 95% CI -2.94 to 0.14; participants = 23; studies = 1; I(2) = 0%).Subgroup analyses conducted on the AQLQ outcome did not suggest a clear difference between individual and group CBT, baseline psychological status, or CBT model. The small number of studies and the variation between their designs, populations, and other intervention characteristics limited the conclusions that could be drawn about these possibly moderating factors.The inability to blind participants and investigators to group allocation introduced significant potential bias, and overall we had low confidence in the evidence. AUTHORS' CONCLUSIONS: For adults with persistent asthma, CBT may improve quality of life, asthma control, and anxiety levels compared with usual care. Risks of bias, imprecision of effects, and inconsistency between results reduced our confidence in the results to low, and evidence was lacking regarding the effect of CBT on asthma exacerbations, unscheduled contacts, depression, and medication adherence. There was much variation between studies in how CBT was delivered and what constituted usual care, meaning the most optimal method of CBT delivery, format, and target population requires further investigation. There is currently no evidence for the use of CBT in adolescents with asthma

Psychometric properties of the university student engagement inventory among Chinese students

Purpose: Since the onset of the COVID-19 pandemic in China, student engagement in online learning has been a critical issue for all educational institutions. The university student engagement inventory (USEI) is the most used scale for assessing the construct of student engagement. The present study aimed to evaluate the psychometric properties of the USEI among 1504 Chinese university students who completed a survey through an online platform between December 2020 and January 2021. Design/methodology/approach: In this cross-sectional study, content validity, construct validity and reliability of the scale were assessed. Findings: The results supported the three-factor model with acceptable goodness-of-fit (χ2 (71) = 369.717, p = 0.13, χ2/df = 5.207, comparative fit index (CFI) = 0.967, normed fit index (NFI) = 0.960, Tucker–Lewis index (TLI) = 0.958, standardized root mean square residual (SRMR) = 0.030, root mean square error of approximation (RMSEA) (90% CI) = 0.053 [0.049, 0.057]), good internal consistency and construct reliability (Cronbach's alpha and omega coefficient &gt;0.70), and strong convergent validity. Also, the measurement invariance was confirmed across gender. Originality/value: This study showed that the 3-factor structure of USEI with Chinese university students had good construct validity, internal consistency and reliability. It could help measure student engagement in online learning in China.</p

Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment

Objective This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia. Method A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined. Results Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001). Significance of results The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context. Copyright © The Author(s), 2020. Published by Cambridge University Press

E-learning Acceptance: The Mediating Role of Student Computer Competency in the Relationship Between the Instructor and the Educational Content

Drawing on the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), this online cross-sectional study explored the mediating role of computer competencies in the relationship between the instructors’ role and the course's educational content with e-learning acceptance among 403 nursing students in Iran. Based on the results, e-learning acceptance was predicted by students’ computer competency (β=.18, p<.001). Computer competency mediated the association between the instructor's role and course content with e-learning acceptance

The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability:a multi-country study on the relationship between parental vaccine hesitancy and financial well-being

Background and purpose: Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents. Method: A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire. Results: The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy. Conclusion: The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children. Copyright © 2023 Sharif Nia, Allen, Arslan, Kaur, She, Khoshnavay Fomani, Gorgulu and Sivarajan Froelicher

Attachment:the mediating role of hope, religiosity, and life satisfaction in older adults

BACKGROUND: Attachment and support from family and friends are core to the experiences of ageing for older adults. The purpose of this study is to examine the relationships between attachment styles and hope, religiosity, and life satisfaction and provide new knowledge that may assist future planning for a rapidly ageing global population. METHODS: In this cross-sectional study, 504 Iranian older adult participants from Qazvin province were recruited between December 2015 and April 2016. They completed a questionnaire that included the Revised Adult Attachment Scale, the Life Satisfaction Index-Z, and the Herth Hope Index. RESULTS: Participants in the study had a mean age of 66.20 years (SD: 5.76) and most of them were women (57.5%). A mediation model testing the direct relationships between attachment, hope, religiosity, and life satisfaction showed a positive relationship between close attachment and religiosity (β = .226, p < .001) and a negative relationship between anxiety attachment and religiosity (β =  - .229, p < .001). Religiosity was positively related to hope (β = .384, p < .01) and hope was related to life satisfaction (β = .448, p < .001). Religiosity and hope mediated the relationship between close attachment (β = .119, p < .001) and anxiety attachment (β =  - .056, p < .01) with life satisfaction. More specifically, while religiosity and hope fully mediated the relationship between close attachment and life satisfaction, they partially mediated the attachment anxiety-life satisfaction link. CONCLUSIONS: Findings of the study provide insight into only a narrow perspective of life satisfaction and attachment given the many and varied variables that influence these constructs. Future research is needed whereby other related variables are introduced into the model to be examined further

A time-series prediction model of acute myocardial infarction in northern of Iran: the risk of climate change and religious mourning.

BackgroundAlthough various studies have been conducted on the effects of seasonal climate changes or emotional variables on the risk of AMI, many of them have limitations to determine the predictable model. The currents study is conducted to assess the effects of meteorological and emotional variables on the incidence and epidemiological occurrence of acute myocardial infarction (AMI) in Sari (capital of Mazandaran, Iran) during 2011-2018.MethodsIn this study, a time series analysis was used to determine the variation of variables over time. All series were seasonally adjusted and Poisson regression analysis was performed. In the analysis of meteorological data and emotional distress due to religious mourning events, the best results were obtained by autoregressive moving average (ARMA) (5,5) model.ResultsIt was determined that average temperature, sunshine, and rain variables had a significant effect on death. A total of 2375 AMI's were enrolled. Average temperate (°C) and sunshine hours a day (h/day) had a statistically significant relationship with the number of AMI's (β = 0.011, P = 0.014). For every extra degree of temperature increase, the risk of AMI rose [OR = 1.011 (95%CI 1.00, 1.02)]. For every extra hour of sunshine, a day a statistically significant increase [OR = 1.02 (95% CI 1.01, 1.04)] in AMI risk occurred (β = 0.025, P = 0.001). Religious mourning events increase the risk of AMI 1.05 times more. The other independent variables have no significant effects on AMI's (P &gt; 0.05).ConclusionResults demonstrate that sunshine hours and the average temperature had a significant effect on the risk of AMI. Moreover, emotional distress due to religious morning events increases AMI. More specific research on this topic is recommended

Spiritual well-being, social support, and financial distress in determining depression:the mediating role of impact of event during COVID-19 pandemic in Iran

This study investigates the relationship between spiritual well-being, social support, and financial distress with depressive symptoms due to the COVID-19 pandemic. A path analysis was used to analyze data collected from 1,156 Iranian participants via an online survey. The results showed that spiritual well-being and social support were negatively related to depressive symptoms and financial distress. The impact of COVID-19 events showed negative associations with depressive symptoms. In addition, the link between spiritual well-being and financial distress with depressive symptoms was partially mediated by the impact of events