Medicine and Health Sciences Commons^™

Unveiling Unwritten Curricula: Enhancing Junior Faculty Development In Academic Emergency Medicine, Abagayle Bierowski, Casey Morrone, Erin Hoag, Ridhima Ghei, Michael Pasirstein, Julie Blaszczak, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

INTRODUCTION: The transition from resident to junior faculty in academic emergency medicine (EM) may be shaped not only by formal training and institutional policies but also by the "unwritten curriculum," a set of norms and expectations embedded in institutional culture. However, the unwritten curriculum and its potential to impact junior faculty development remains largely unexplored. Little is known about how junior faculty perceive, experience, and navigate these informal expectations, or the formal and informal structures that influence this process. In this study we aimed to explore junior faculty members' experiences with the unwritten curriculum in academic EM, with a focus …

Pharmaceutical Industry Manufacturing Trend For Tablet Dosage Forms And Opportunities For The Future: A Case Study Of Current Practice And Future Developments, Tarang Patel

Discovery Day

INTRODUCTION: Tablet dosage forms remain the most widely utilized oral drug delivery system due to their stability, ease of administration, cost-effectiveness, and scalability. Over recent decades, advancements such as high-speed compression, improved granulation techniques, and regulatory frameworks (bioavailability, validation, and quality assurance) have significantly shaped modern pharmaceutical manufacturing. However, current systems remain largely semi-automated and resource-intensive, highlighting the need for technological transformation.

METHOD: This study presents a case-based evaluation of a contemporary pharmaceutical tablet manufacturing facility. The analysis maps the complete production workflow, including material handling, dispensing, granulation, lubrication, compression, coating, inspection, and packaging. Operational practices were reviewed alongside quality …

Review Of: A Fragile Heritage: Untangling The Strands Of Faith And Mutation—Sheryl Leinbach, Beth Bennett, Karen Conley

Journal of Amish and Plain Anabaptist Studies

Get ready for an emotional roller coaster with parallel intellectual stimulation while reading Sheryl Leinbach’s A Fragile Heritage. Sheryl authentically describes the span of emotions and challenges faced by the mother of a child with Maple Syrup Urine Disease (MSUD), from birth through successful liver transplant. The book invites the reader to accompany the author on a journey of growing faith, intellectual expansion, and societal reflection as the family navigates through the turbulence of loving a notably broken child in a fallen world. [First paragraph.]

Workplace Environmental Exposures And Related Health Conditions Among Amish & Mennonite Women In Ohio, Lora Wyss, Ratchneewan Ross, Rosanna Hess

Journal of Amish and Plain Anabaptist Studies

Background: Although it is known that some plain (Amish and conservative Mennonite) women work in furniture finishing shops, commercial greenhouses, and on family farms, little is known about their exposure to harmful conditions and substances in those work environments and the incidence of any related illnesses. Aim: To assess the relationship between the exposure to potentially harmful environmental conditions and general health conditions, work-related illnesses, and work-related injuries, comparing adult plain women with adult women of the general population. Methods: Data in this exploratory, concurrent, mixed methods study were collected using a 24-item survey and semi-structured interviews. Descriptive and correlational …

The Impact Of Psychosocial Factors On The Recovery Of Upper Extremity Injuries And Trauma: A Systematic Review, Meghan Hall, Abigail Morgan, Annie Knight, Tanner Fletcher, Allison G. Freeman, Sharon M. Cosper

Journal of Applied Disciplines

This systematic review specifically addresses the question of identifying what psychosocial factors for individuals with upper extremity conditions impact recovery. Twenty two studies were examined with four themes arising: coping limitations, anxiety/stress, depression, and kinesophobia/pain. While extensive research exists to support the presence of an impact of psychosocial factors in upper extremity rehabilitation, further research should be done to expand on these findings to include how psychosocial factors effect rehabilitation of individuals with upper extremity conditions, and application of how these relate to the field of occupational therapy and quality of life.

Exploring Psychological Traits And Feedback Strategies In Physical Therapy Providers Learning Acceptance And Commitment Therapy, Dustin Cox

Journal of Applied Disciplines

Providing treatment interventions to clients with chronic pain is a complex task for any professional. Research suggests that clients with chronic pain experience declines in physical, emotional, and psychological quality of life. Client’s that have chronic pain have complex effects from dealing with this condition in their lives. Clients with chronic pain (i.e., pain lasting > three months) process pain through the emotional and reward circuitry in the brain which is different than client with acute pain. The literature base provides evidence that clients with chronic pain who receive psychologically based interventions along with physical rehabilitation have better outcomes than individuals …

Self-Management For Youth And Young Adults With Childhood-Onset Chronic Conditions: A Scoping Review Of Health Care Transition Planning Literature, Jennifer Emilie Mannino Ph.D., R.N., Cne, Cara C. Young, Monique M. Ridosh, Kristin Cleverley, Lin Li, Lynn Kysh, Catherine A. Harwood, Brooke Allemang, Linda Tirabassi-Mathis, Sharon Hudson, Stephanie M. Key, Benjamin C. Schwartzman, Jihye Lee, Manu Raam, Cecily L. Betz

Nursing: Faculty Publications

Objective: To determine the extent to which self-management has been investigated and reported in literature focused on the transition from pediatric to adult healthcare for youth and young adults with childhood-onset chronic conditions (CCCs).

Introduction: An estimated 1.2 million youth with CCCs are expected to enter adulthood annually in the United States. As these youth transition from pediatric to adult health systems, they are at risk for experiencing critical gaps in care continuity and adverse health outcomes. Health care transition models have emerged to address these gaps, with self-management recognized as a critical component of successful transition.

Inclusion criteria: The …

Long-Term Functional Synaptic Integration Of Genome-Edited Retinal Organoids In A Primate Model Of Macular Degeneration, Atsuta Ozaki, Akihiro Kawai, Ryutaro Akiba, Satoko Okayama, Nobuhiko Ohno, Keisuke Kajita, Tomohiro Masuda, Satoshi Yokota, Shin-Ichiro Ito, Du Peiyan, Kenta Onoue, Shigenobu Yonemura, Mineo Kondo, Yasuo Kurimoto, Yingbin Fu, Michiko Mandai

Faculty, Staff and Students Publications

Retinal organoids represent a promising regenerative strategy for restoring vision in retinal degenerative diseases, but the capacity of host cone bipolar cells in the primate macula to rewire with transplanted photoreceptors has not been established. In this study, we transplanted genome-edited ISL1-/- human retinal organoids lacking ON-bipolar cells into an acute laser-induced macular photoreceptor ablation non-human primate model. Using immunohistochemistry, ultrastructural imaging, and focal macular electroretinography, we demonstrate that host rod and cone bipolar cells actively extend dendrites toward grafted photoreceptors and form synaptic contacts, with evidence of functional signal transmission in a subset of transplanted eyes. Longitudinal, per-eye analyses …

Patent Ductus Arteriosus Spasm During Percutaneous Device Occlusion In Infants And Children, Hani M. Adel, Ashraf K. Mahmoud

Journal of the Saudi Heart Association

Background: Spasm of ductus arteriosus is an uncommon but significant phenomenon associated with transcatheter patent ductus arteriosus (PDA) occlusion. It can lead to procedural failure, improper device sizing, or even embolization of the occluder device as the spasm subsides post-procedure. Aim of this study is to report the frequency, features, management and outcome of PDA spasm during device closure in a single Egyptian center.

Patients and methods: Over about 3 years, 200 infants and children underwent percutaneous device occlusion. The echocardiographic and catheterization data of patients who developed spasm of PDA before or during or shortly after anesthesia …

Enhancing Research Communication With Visual Tools, Sonya Fogg

Library Class: Lunch & Learn

Understand the role of visual communication in medical research. Distinguish between data visualizations, infographics, and visual abstracts. Identify best practices and some resources and tools for creating effective visuals.

Teachers’ Awareness Of Family Engagement In Multilingual Education, Sedighe Zamani Roodsari

Journal of Multicultural Affairs

This study investigated public school teachers’ awareness of family engagement as a linguistic and cultural resource for multilingual students. Multilinguals are typically described as individuals who can communicate in more than one language, with English not being their native language, and their linguistic choices are influenced by societal norms and systems (Šifrar Kalan et al., 2024; Wei, 2008). Preparing pre-service teachers to enhance opportunities for multilingual students remains a critical need in teacher education programs, as they strive to move beyond monolingual ideologies in their teaching practices (Cárdenas Curiel et al., 2024; Kim & Choi, 2020; Williams & Ewing, 2019). …

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …

Mimickers Of Atrial Fibrillation: When All Irregular Rhythms Are Not Atrial Fibrillation, Tirumala Nischal Jasty, Devi Parvathy Jyothi Ramachandran Nair

Transformative Medicine

Atrial fibrillation (AFib) is the most common sustained cardiac arrhythmia and carries important therapeutic implications, particularly regarding anticoagulation and stroke prevention. However, AFib remains frequently misdiagnosed, often due to overreliance on automated electrocardiogram (ECG) interpretations and failure to recognize alternative causes of rhythm irregularity. This review highlights the fundamental ECG characteristics required for the diagnosis of AFib and emphasizes that not all irregular rhythms represent atrial fibrillation. Through a representative clinical case and discussion of common mimickers—including Mobitz I (Wenckebach) atrioventricular block, premature atrial contractions, blocked premature atrial contractions, multifocal atrial tachycardia, and sinus arrhythmia—we demonstrate key electrocardiographic features that …

Patient Activation Measures Among Individuals With Epilepsy: A Cross-Sectional Study Of An Arabic-Speaking Population, Ghada M. Abbas, Abeer A. Khoja, Haythum O. Tayeb, Nagham S. Alsolaimani, Ibrahim M. Aldurayhim, Saher F. Alqarni

Neurosciences

Objectives: To examine patient activation levels among Arabic-speaking adults with epilepsy and to explore their associations with selected clinical and sociodemographic variables.

Methods: We conducted a cross-sectional study of 109 adult patients with confirmed epilepsy between December 2023 and October 2025. Data were collected during outpatient clinic visits, with additional information obtained through telephone contact when necessary. A sample size estimate indicated that at least 96 participants were required to achieve 80% statistical power. Patient activation was assessed using the validated Arabic version of the 13-item Patient Activation Measure (PAM-13). The variables examined included seizure type, medication regimen (monotherapy versus …

Antiseizure Drug Adherence In Pediatric Patients With Epilepsy And The Associated Factors In Saudi Arabia, Ola A Shawky, Shaima A Althoubaiti, Reham M Alkahtani, Amirah S Alharthi

Neurosciences

Objectives: To assess the prevalence of adherence to antiseizure medications and related factors in Saudi Arabia. Pediatric epilepsy presents significant challenges to the well-being and quality of life of children. Adherence to antiseizure medication is associated with better outcomes.

Methods: This study was carried out using a cross-sectional methodology to determine the prevalence of antiseizure medication adherence among children with epilepsy aged ≤ 17 years in Saudi Arabia. Data were collected between July and September 2024 via an online self-administered questionnaire, using convenience sampling through social platforms (Telegram and WhatsApp). Medication adherence was assessed using the MMAS-8 and categorized as …

Quality Improvement Project: Improving Confidence And Clinical Judgment Through Simulation Remediation In Nursing Students, Erica Gillespie

Doctor of Nursing Practice Projects

Simulation is a critical component of nursing education, providing students with a safe environment to develop clinical judgment and confidence before entering clinical practice. However, students may experience anxiety and difficulty meeting competency expectations during simulation. This quality improvement project evaluated whether structured simulation remediation improved confidence and clinical judgment among associate degree nursing students. The project was guided by the NLN Jeffries Simulation Framework, and Kotter’s 8-Step Change Model supported implementation. A quantitative, quasi-experimental pre-/post- intervention design was used. Nine nursing students voluntarily participated. During remediation, students reviewed recordings of their initial simulation experiences and completed guided reflection questions …

Folr1-Targeted Actinium-225-Based Alpha-Particle Therapy Eliminates Ovarian Cancer, Neetu Singh, Esther Need, Ayden Berndt, Matthew Goff, Lydia J. Wilson, Firas Mourtada, Feng Guo, Tara Mastren, Taslim Al-Hilal, Anil K. Sood, Amit Maity, Scott C. Miller, Satoshi Minoshima, Shreya Goel, Sixiang Shi

Department of Radiation Oncology Faculty Papers

Despite the advancement in therapies, ovarian cancer treatment is challenging because of poor prognosis and high relapse associated with acquired resistance. Emerging targeted alpha particles, particularly actinium-225 (225Ac), for treating refractory cancers have opened avenues for improved therapeutic options. Here, we describe a successful example of folate receptor 1 (FOLR1)–targeted 225Ac alpha-particle therapy for treatment of ovarian cancer. Longitudinal positron emission tomography imaging demonstrated high tumor-specific uptake of αFOLR1 (anti-FOLR1 antibody) in SKOV3 xenografts. FOLR1-targeted 225Ac demonstrated high therapeutic efficacy, achieving marked tumor regression, 80% survival, and 40% complete tumor elimination. The therapy resulted in tumor-specific double-stranded DNA damage, and …

Cerebrovascular And Bleeding Outcomes Of Warfarin Versus Direct Oral Anticoagulants Therapy For Atrial Fibrillation: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Abeer A. Alomairi, Rana Alduhaysh, Alaa Samandar, Abeer Alshehri, Ghada Alabdullah, Saud Almutairi, Faisal Althekair

Neurosciences

Objectives: To compare the effects on cerebral health in atrial fibrillation patients receiving either warfarin or direct oral anticoagulants (DOACs). Atrial fibrillation is linked to a higher likelihood of both stroke and cognitive impairment. While warfarin has historically served as the leading anticoagulant treatment, DOACs are now more frequently viewed as alternatives with an improved safety profile.

Methods: The methodology involved an extensive search of multiple databases, completed up to June 2024. This search yielded randomized controlled trials, which together enrolled over 60,000 participants between the ages of 70 and 84. The DOACs studied were dabigatran, rivaroxaban, apixaban, and edoxaban, …

A Systematic Comparative Review Of Antipsychotic Efficacy And Safety In The Treatment Of Hiccups, Omar Alshargi, Samah Alzaid, Zainab Albahouth, Muradi Hassan Albanji, Hala Makki, Rawan. F. Alboqami, Maram Al Shammari, Huda Alruwaili, Fawaz Alruwaili, Rahmah Ali Algarni, Omar Ibrahim Albahouth

Neurosciences

Objective: To evaluate and compare the safety and effectiveness of antipsychotic medications for the treatment of hiccups, thereby guiding clinicians toward evidence-based treatment guidelines. Hiccups are often benign and self-limiting; however, they can become persistent and intractable, adversely affecting the quality of life. Antipsychotics have been identified as a therapeutic option for the management of hiccups; however, the available evidence supporting their safety and efficacy has not been synthesized.

Methods: This review utilized the revised Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Cochrane Risk of Bias Assessment Tool was modified to evaluate the quality of the …

Subliminal Priming Effects On Motor And Cognitive Performance: Pilot Evidence With Implications For Neurorehabilitation, Rehab E Aljuhni, Ghader A Alqadhi, Saud A Alhassan, Sultan A Alanazi

Neurosciences

Objective: To investigate whether subliminal priming modalities (visual, auditory, or word-based) influence motor and cognitive performance in healthy young adults, and whether these effects vary by gender.

Methods: A total of 30 healthy adults were assigned to visual, auditory, or word-based priming using single-blind, stratified randomization. Subliminal stimuli were presented for 50 ms. Motor outcomes included reaction time on dominant (RT-R) and non-dominant (RT-L) sides, comfortable and maximal walking speeds measured by the 10-Meter Walk Test (10MWT), and functional mobility assessed using the Timed Up and Go (TUG) test. Cognitive performance assessed using the Trail Making Test (TMT). Outcomes were …

Sub-Regional Motor–Somatosensory Connectivity And Lifespan Plasticity In Functional Networks, Adnan A. S. Alahmadi

Neurosciences

Objectives: To determine how cytoarchitectonically defined subdivisions of the primary motor cortex, somatosensory cortex, and supplementary motor area (SMA) reorganize their integration with large-scale brain networks during healthy aging. This study investigated the lifespan trajectories of functional connectivity within cytoarchitectonically defined subregions of the primary motor cortex, somatosensory cortex, and supplementary motor area (SMA).

Methods: We conducted a cross-sectional analysis of resting-state fMRI data from 150 healthy individuals (aged 23–80 years), stratified into young, middle-aged, and older groups. Data were sourced from the Southwest University Adult Lifespan Dataset (SALD) and analyzed between June 2024 and June 2025. Using the Jülich …

Relationships Between The Corpus Callosum Index And Current Blood Parameters And Temporal Changes In These Parameters In Patients With Multiple Sclerosis, Oruç Şahin, Muzaffer Güneş

Neurosciences

Objectives: This study aimed to investigate changes in blood parameters and examine the relationships among the corpus callosum index (CCI), plaque characteristics, and blood parameters in multiple sclerosis (MS) patients. In MS, the CCI is associated with brain atrophy and disease progression.

Methods: In this retrospective, cross-sectional study, demographic data from 103 MS patients (38 males), along with blood parameters obtained five years earlier and current values, were analyzed in relation to magnetic resonance imaging (MRI) findings. The CCI calculated from MRI scans was assessed in relation to plaque distribution and number. Statistical analyses included paired sample t tests, Wilcoxon …

Clinical Characteristics Of Multiple Sclerosis And Association Of Ms Severity With Vitamin D Level In The Madinah Region Of Saudi Arabia: A Cross-Sectional Study, Majed M. Alluqmani

Neurosciences

Objective: To determine the prevalence of multiple sclerosis (MS) in the western region of Saudi Arabia and correlate it with its predictors among a cohort of patients. The prevalence of MS is increasing in Saudi Arabia, and is attributed to various factors such as recent lifestyle changes, improved disease recognition, and parental consanguinity. Knowing the exact prevalence of the disease may enhance disease management.

Methods: This cross-sectional study was conducted among individuals diagnosed with MS at clinics in the Madinah region.

Results: The study found that the prevalence of multiple sclerosis is lower in the Madinah region. Additionally, …

The Top 50 Cited Articles In Pediatric Neurology: A Bibliometric Analysis, Anas Alyazidi, Osama Muthaffar, Ahmed Bamaga, Hebah Qashqari, Abdulmalek Alhithlool, Ahmad Alanezi, Sameer Almehmadi, Mohamed Babiker, Fahad Bashiri

Neurosciences

Objectives: To identify and analyze the most influential articles within the field of pediatric neurology through a bibliometric lens. As pediatric neurology continues to expand across subspecialties, identifying landmark studies is critical for understanding clinical and research priorities. Bibliometric analysis enables the evaluation of citation trends to highlight impactful contributions that have shaped the field.

Method: A bibliometric analysis of the 50 most-cited pediatric neurology articles was conducted. Articles were assessed by citation metrics, study design, subspecialty, journal impact factor (JIF), and funding status. Correlation and regression analyses evaluated associations between variables.

Results: Citation counts ranged from 185 to 1,440 …

Prevalence Of Depression Among Patients With Epilepsy In Saudi Arabia: A Nationwide Systematic Review And Meta-Analysis, Mothana Y. Al Jabr, Aryam M. Alenizi, Faisal S. Aleisa, Mazen A. Alghamdi, Noura I. Alfehaid, Muteb M. Alqahtani, Abbas S. Almutair

Neurosciences

Objective: To assess the pooled prevalence of depression among epilepsy patients and find the associated demographics and psychosocial factors. Mood disorders are significant comorbidity between patients diagnosed with epilepsy, adversely influencing quality of life and complicating disease management. However, the incidence, prevalence, and associated risk factors of depression in patients diagnosed with epilepsy in Saudi Arabia are not well elucidated.

Methods: This review was employed used studies retrieved from medical databases and the Saudi Digital Library. Observational and cross-sectional studies assessing depression between patients diagnosed with epilepsy in Saudi Arabia were included. Data were analyzed using the Freeman–Tukey double arcsine …

Wearable Sensor Technology And Biomechanical Gait Analysis In Post-Stroke Rehabilitation: A Review With Implications For The Saudi Healthcare System, Abdullah H. Alzahrani

Neurosciences

Stroke remains a major cause of disability worldwide, with gait impairment affecting up to 80% of survivors and contributing to long-term dependence, fall risk, and reduced quality of life. In Saudi Arabia, stroke incidence is rising, with a significant burden on younger populations and disparities in access to post-stroke rehabilitation services. Conventional gait analysis tools rely on expensive, specialized laboratory equipment, which limits their availability in low-resource and rural settings. Recent advances in wearable sensor technologies, including inertial measurement units, pressure insoles, and electromyography systems, offer portable, scalable, and cost-efficient options for assessing gait in real-world environments. These systems can …

Fatigue And Depression In Epilepsy Patients May Not Be Solely Related To The Epilepsy Itself, Sounira Mehri, Josef Finsterer

Neurosciences

No abstract provided.

Efficacy And Safety Of Plasma Exchange And Immunoadsorption For Acute Optic Neuritis In Patients With Demyelinating Diseases: A Systematic Review And Meta-Analysis, Mehenaz A Hanbazazh, Mohammed Ridha Algethami, Abdulwahhab Omar Anbarserry, Ruba Mohammed Alghanmi, Lama Nawaf Alanazi, Ahmed Ayed N Alanazi, Bashaier Gubran Alqahtani, Mohammed Abdullah Alamri

Neurosciences

Background: Optic neuritis (ON), a common manifestation of demyelinating disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), often leads to significant visual impairment. Although high-dose corticosteroids are a first-line therapy, many patients experience incomplete recovery. Apheresis therapies, including plasma exchange (PLEX) and immunoadsorption (IA), are being increasingly used as rescue treatments, but their efficacy and safety are debated.

Methods: We conducted a systematic review and meta-analysis of studies evaluating PLEX and IA for acute ON in patients with demyelinating diseases. Four databases were searched up to January 2025. The included …

Investigating The Patent Foramen Ovale–Migraine Link In Southern Saudi Arabia, Al-Amir Bassiouny Mohamed, Maeed Alkathiri, Saad Mushabab Ali Alqahtani, Naif H. Ali, Saima Kashif, Saad A. Alshahrani, Mohammed S. Alqahtani, Mohamed Gaber Mahmoud Gabr, Eltohami Zydan Dafalla, Basharat Hameed Zargar, Wael Qenawi, Ali Mohammed A. Alshehri, Fatimah Asiri, Ahmed Borai

Neurosciences

Objective: Migraine is a highly disabling neurological condition, and increasing attention has focused on a possible connection with patent foramen ovale (PFO).

Methods: This single-center observational study enrolled 45 individuals from January to April 2024: 30 migraine patients with PFO (Group 1) and 15 migraine patients without PFO serving as controls (Group 2). All subjects underwent transthoracic echocardiography and completed standardized instruments including the Migraine Disability Assessment (MIDAS), Headache Impact Test (HIT-6), Migraine Symptom Severity Scale (MSSS), Allodynia Symptom Checklist (ASC-12), Visual Aura Rating Scale (VARS), and Migraine Treatment Optimization Questionnaire (mTOQ-6).

Results: The participant's mean age was 37.3 ± …

Faktor Yang Berhubungan Dengan Keaktifan Pelaporan Bahaya K3 Pada Pekerja Pelabuhan Batu Bara: Studi Cross-Sectional, Samuel Adi Kristiawan, Dewi Puspito Sari, Nur Ani, Wartini Wartini

National Journal of Occupational Health and Safety

Active hazard reporting is a key indicator in preventing workplace accidents and strengthening safety culture, particularly in high-risk industries such as coal port services. This study aimed to analyze internal and external factors associated with active hazard reporting among workers in the coal port services industry. A quantitative cross-sectional study with total sampling was conducted involving all workers (N = 130). Data were collected using a structured questionnaire measuring accident history, unsafe actions, unsafe conditions, supervisor support, performance appraisal, risk level, and hazard reporting activity. Univariate and bivariate analyses were performed using the Chi-Square test. The results showed that 66.2% …