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vector-pinnable-header-pinned" data-feature-name="toc-pinned" data-pinnable-element-id="vector-toc" > <h2 class="vector-pinnable-header-label">Contents</h2> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-toc.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-toc.unpin">hide</button> </div> <ul class="vector-toc-contents" id="mw-panel-toc-list"> <li id="toc-mw-content-text" class="vector-toc-list-item vector-toc-level-1"> <a href="#" class="vector-toc-link"> <div class="vector-toc-text">Beginning</div> </a> </li> <li id="toc-GHQ12-cohort_protocol" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#GHQ12-cohort_protocol"> <div class="vector-toc-text"> <span class="vector-toc-numb">1</span> <span>GHQ12-cohort protocol</span> </div> </a> <ul id="toc-GHQ12-cohort_protocol-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-ABSTRACT" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#ABSTRACT"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>ABSTRACT</span> </div> </a> <button aria-controls="toc-ABSTRACT-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle ABSTRACT subsection</span> </button> <ul id="toc-ABSTRACT-sublist" class="vector-toc-list"> <li id="toc-Background" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Background"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Background</span> </div> </a> <ul id="toc-Background-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Objectives" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Objectives"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Objectives</span> </div> </a> <ul id="toc-Objectives-sublist" class="vector-toc-list"> <li id="toc-For_the_maritime_students" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#For_the_maritime_students"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.1</span> <span>For the maritime students</span> </div> </a> <ul id="toc-For_the_maritime_students-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-For_the_seafarers" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#For_the_seafarers"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.2</span> <span>For the seafarers</span> </div> </a> <ul id="toc-For_the_seafarers-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Methods" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Methods"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Methods</span> </div> </a> <ul id="toc-Methods-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Expected_results" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Expected_results"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Expected results</span> </div> </a> <ul id="toc-Expected_results-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-BACKGROUND_2" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#BACKGROUND_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>BACKGROUND</span> </div> </a> <ul id="toc-BACKGROUND_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Invitation_to_the_schools" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Invitation_to_the_schools"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Invitation to the schools</span> </div> </a> <ul id="toc-Invitation_to_the_schools-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Objectives_2" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Objectives_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Objectives</span> </div> </a> <ul id="toc-Objectives_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Scientific_aims" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Scientific_aims"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Scientific aims</span> </div> </a> <ul id="toc-Scientific_aims-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Occupational_stress_and_depression_etiological_models" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Occupational_stress_and_depression_etiological_models"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Occupational stress and depression etiological models</span> </div> </a> <ul id="toc-Occupational_stress_and_depression_etiological_models-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Methods_2" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Methods_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Methods</span> </div> </a> <ul id="toc-Methods_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Long-term_follow-up_of_the_cohort" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Long-term_follow-up_of_the_cohort"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Long-term follow-up of the cohort</span> </div> </a> <ul id="toc-Long-term_follow-up_of_the_cohort-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Data_processing" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Data_processing"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Data processing</span> </div> </a> <ul id="toc-Data_processing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Data_analysis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Data_analysis"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Data analysis</span> </div> </a> <ul id="toc-Data_analysis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ethical_requirements" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Ethical_requirements"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>Ethical requirements</span> </div> </a> <ul id="toc-Ethical_requirements-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Dissemination_of_results" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Dissemination_of_results"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>Dissemination of results</span> </div> </a> <ul id="toc-Dissemination_of_results-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Work_plan" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Work_plan"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>Work plan</span> </div> </a> <ul id="toc-Work_plan-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">15</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button 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</div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikiversity</div> </div> <div id="contentSub"><div id="mw-content-subtitle"><div class="subpages">< <bdi dir="ltr"><a href="/wiki/Maritime_Health_Research_and_Education-NET" title="Maritime Health Research and Education-NET">Maritime Health Research and Education-NET</a></bdi> | <bdi dir="ltr"><a href="/wiki/Maritime_Health_Research_and_Education-NET/Cohort_protocols" title="Maritime Health Research and Education-NET/Cohort protocols">Cohort protocols</a></bdi></div></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><p><a class="external text" href="https://es.wikiversity.org/wiki/GHQ12-protocolo">->Español</a> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="GHQ12-cohort_protocol">GHQ12-cohort protocol</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=1" title="Edit section: GHQ12-cohort protocol" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=1" title="Edit section's source code: GHQ12-cohort protocol"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The psycho-social study environment in the maritime universities and on board the ships. <br /> </p> <div class="mw-heading mw-heading2"><h2 id="ABSTRACT">ABSTRACT</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=2" title="Edit section: ABSTRACT" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=2" title="Edit section's source code: ABSTRACT"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Background">Background</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=3" title="Edit section: Background" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=3" title="Edit section's source code: Background"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Stress among students is well known but a suspected excess study related to stress and the GHQ12 has not so far been used to evaluate the stress among maritime students. The GHQ12 survey in the maritime schools completes part of the diagnostics of a global mental health program at the schools and workplaces, also related to the WHO program: <a rel="nofollow" class="external text" href="https://learningportal.iiep.unesco.org/en/library/the-who-health-promoting-school-framework-for-improving-the-health-and-well-being-of?back_url=/en/library/search/occupational%20health%20research">The WHO health promoting school-framework for improving the health and well being</a>.There is little knowledge on mental health, bullying, sexual harassment, smoking, alcohol, among the maritime students. Better knowledge is needed to improve the educational environmental conditions for the maritime students and the seafarers to inspire them to stay in the profession. </p> <div class="mw-heading mw-heading4"><h4 id="Objectives">Objectives</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=4" title="Edit section: Objectives" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=4" title="Edit section's source code: Objectives"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading5"><h5 id="For_the_maritime_students">For the maritime students</h5><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=5" title="Edit section: For the maritime students" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=5" title="Edit section's source code: For the maritime students"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To evaluate the mental health, bullying, sexual harassment, smoking, alcohol, among and the maritime students and their evaluation of the precautions taken by the maritime schools </p> <div class="mw-heading mw-heading5"><h5 id="For_the_seafarers">For the seafarers</h5><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=6" title="Edit section: For the seafarers" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=6" title="Edit section's source code: For the seafarers"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To evaluate the well-being of the seafarers and the evaluation of the precautions taken by the shipping companies. It is very important to correctly assess the stress risk of these sea workers. In fact, the role of the bio-humoral influences of stress on the immune system and not only on the psychological structure of workers and therefore on the organization of work is well known. </p> <div class="mw-heading mw-heading4"><h4 id="Methods">Methods</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=7" title="Edit section: Methods" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=7" title="Edit section's source code: Methods"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A sample of seafarers is asked to complete the General Health Questionnaire (GHQ) and to evaluate the stress precautions taken on board. This is a pilot study and lays the foundations for further larger studies, always based on questionnaires, or even on other methods of assessing work-related stress, also with the search for laboratory-level stress markers. The questionnaires are on mental health, bullying, sexual harassment, smoking, alcohol, and the students ‘suggestions on how to create an inspiring learning environment. </p> <div class="mw-heading mw-heading4"><h4 id="Expected_results">Expected results</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=8" title="Edit section: Expected results" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=8" title="Edit section's source code: Expected results"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Seafarers have increased work-related stress levels compared to shore workers due to the specific work situation. However, we expect that someone needs more support, not only in terms of security measures but also on a psychological level. if the situation of excess risk-related work stress is confirmed, it would be interesting in the future to investigate the stress of mariners also from a bio-humoral point of view to have a more objective point of view. There is a need to integrate stress prevention in the maritime universities and these surveys will be part of the learning program. </p> <div class="mw-heading mw-heading2"><h2 id="BACKGROUND_2">BACKGROUND</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=9" title="Edit section: BACKGROUND" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=9" title="Edit section's source code: BACKGROUND"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>This protocol under development is intended to be used as a standard protocol for the completion of the GHQ12 cross-sectional studies in MAHRE-NET. The GHQ12 survey in the maritime schools is part of the diagnostics in a global mental health program at the maritime workplaces <a rel="nofollow" class="external text" href="https://www.dropbox.com/s/y2dhnx9e2pnhpyf/2017%20The%20global%20mental%20health%20IJCFM-134.pdf?dl=0">Jensen O, Canals M & A Bygvraa D. 2017</a> and <a rel="nofollow" class="external text" href="https://www.dropbox.com/s/aa1lmtf4juxws17/2019%20Mental%20health%20promotion%20program%20apmh-aid1004-F.pdf?dl=0">Jensen et al. 2019</a> The seafaring employees often face more difficult working conditions in the sea than the employees working on the land. Their mental health is affected by the environment in which they live, often coupled with long working hours that contribute to stress, anxiety, loneliness, depression, and suicide. This proposal seeks to improve the seafarers’ mental health by introducing a comprehensive, evidence-based global maritime mental health promotion program that attracts the youngest seafarers to choose and to stay in the job. Methods: The theories on empowerment, life-long- and problem-oriented learning with the inclusion of all stakeholders form the theoretical background. Our main task is to create responsibility among all stakeholders to help to create a comprehensive occupational- and public health program at sea that includes the whole maritime industry. The specific physical, chemical and psychological working environment factors on board also relate to the seafarer's health conditions (1)(2)(3). The quality of the mental work environment is dependent on several factors which have been carefully described in the past approx. 30 years (4) (5) (1). Ships with ongoing replacement of crew present great challenges for both the manager and the employees and the culture at the workplace (6). During navigation, the sailors are often moved to very small working groups, where conflict management can be difficult. The requirements are very variable, the nature of the work requires considerable discipline and thus less self-control. Support from superiors and colleagues can be made difficult by the fact that crews come from many different nationalities. These conditions can lead to experienced stress and burnout (7) (1). Fatigue is considered a significant health and safety problem [14]. Jet lag after long flights for joining is described as part of this (8). (12) In the latest research Helen Sampson, director of Cardiff University's Seafarers International Research Centre, said that seafarers working on cargo ships "experience very little happiness on board". (9) She said there was evidence recent-onset psychological disorders were increasing among serving seafarers but 55% of employers said they had not introduced any policies or practices to address mental health for a decade. Seafarers' mental health and well-being found that internet access would make the most significant contribution to improving mental health and well-being together with other key recommendations underscored in the report and the BBC News (Seafarers Mental Health and Well-being Nov. 2019). Jensen and Oldenburg conclude that because of many stressors on board, and the lacking respective education, there is a strong need to integrate stress management in the maritime educations especially for officers <sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Guidelines for prevention <a rel="nofollow" class="external free" href="https://www.copsoq-network.org/assets/Uploads/COPSOQ-network-guidelines-an-questionnaire-COPSOQ-III-131119-signed.pdf">https://www.copsoq-network.org/assets/Uploads/COPSOQ-network-guidelines-an-questionnaire-COPSOQ-III-131119-signed.pdf</a> Authors "soft guidelines" page 7, start with: "Never start a psychosocial risk assessment unless there is a clear intention of taking action if indicated". The psychological stress in seafarers resulting from the Covid pandemic has already been investigated by our MAHRE group with GHQ 12 test. In a small pilot study, it emerged that the category of seafarers did not suffer additional stress from the international situation and that they feel safe at work (10). </p> <div class="mw-heading mw-heading2"><h2 id="Invitation_to_the_schools"><a href="/wiki/Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol/Invitation_to_the_schools" title="Maritime Health Research and Education-NET/Cohort protocols/GHQ12 Cohort protocol/Invitation to the schools">Invitation to the schools</a></h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=10" title="Edit section: Invitation to the schools" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=10" title="Edit section's source code: Invitation to the schools"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The European community underscores the need to take more attention to mental health in all parts of the communities. For the youth and the adults the policy recommendations include <sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> 1. Strengthen information and research on mental health and well-being among children and adolescents. a. Establish a solid information base to have a detailed epidemiological frame of the mental health among children and adolescents and evidence on interventions. b. Provide information on coverage and outcomes of interventions, including for groups at higher risk as well as on the size, impact, cost, and potential economic savings of appropriate interventions. c. Carry out a mapping and analysis of existing screening tools for early identification, from the first developmental stages, of mental health disorders and poor well-being among children and school populations. d. Examine the potential to increase access to information and services through the use of web-based technologies (e-mental health) to promote mental well-being and the prevention of mental and behavioral disorders. The surveys in the maritime schools complete part of the diagnostics of a global mental health program at the schools and workplaces in the WHO health-promoting school-framework for improving the health and well being<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>,<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Objectives_2">Objectives</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=11" title="Edit section: Objectives" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=11" title="Edit section's source code: Objectives"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To provide systematic and current knowledge about the psychosocial working environment for students at the maritime universities. To use scientific methods that are well tested on land and which are supposed to be useful on the ships and thus can ensure relevant and valid results. </p> <div class="mw-heading mw-heading2"><h2 id="Scientific_aims">Scientific aims</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=12" title="Edit section: Scientific aims" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=12" title="Edit section's source code: Scientific aims"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The aim is to help to create an evidence-based Health Promotion Program for maritime workers and the schools. The goal is for everyone to benefit from the project, both for the seafarers and for the company. The project focuses on good psycho-social wellbeing at the University, onboard and in the company with the benefits for all parties the students, teachers, workers, shipping companies, and the community. The scientific aim is to produce data and publications that convey new knowledge of high validity based on the newest scientific principles for the conduct of studies in peer-reviewed publications. </p> <div class="mw-heading mw-heading2"><h2 id="Occupational_stress_and_depression_etiological_models">Occupational stress and depression etiological models</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=13" title="Edit section: Occupational stress and depression etiological models" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=13" title="Edit section's source code: Occupational stress and depression etiological models"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Due to the high prevalence and severe consequences, stress and depressive disorders provide an important challenge to occupational and public health. The literature about etiological models for the development of occupational stress and depression is scarce specifically for GHQ12. More in general for occupational stress and depression, the classical model is the Karasek job control and demand model<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Occupational stress and depression has been described in terms of an interaction between the predisposing, precipitating, and perpetuating factors <sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>. Danasekaran, Raja, and Ravivarman Govindasamy have given a list of suspected etiological risk factors for anxiety and depression <sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> According to Siegrist chronic psychosocial stress at work, demand-control, and effort-reward imbalance, is a modifiable risk factor. Findings from 12 reports indicate a rather consistently elevated odds ratio of about 1.8 of depression among men and women who were exposed to high demand and low control at work or who spent high efforts in combination with low rewards received in turn<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>. </p> <div class="mw-heading mw-heading2"><h2 id="Methods_2">Methods</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=14" title="Edit section: Methods" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=14" title="Edit section's source code: Methods"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An epidemiological, cross-sectional-based study will be performed by the use of mail distributed general Health Questionnaires (GHQ12) are used. The content of the questionnaires is demographic information about the person, questions about the psychosocial work environment, about the way your work affects your private life and family, It is in line with the Danish Maritime Leaders' wishes. Maritime Schools are invited to participate. Standardized questionnaires are sent to the students about smoking, alcohol, mental health, bullying, sexual harassment and suggestions for improving of the education. The students can use it as their final study thesis. The managers can together with the students, use the results to propose concrete improvements to the education and contribute to creating interest among young people in entering the maritime profession. The same model can be used on the ships. If the survey seems to indicate problems with the psychosocial work environment, the work environment committee or other relevant actors at the university should discuss how to act on the basis of the results. If help from the outside is needed, the workplace may contact consultants, the Labour Inspection, or relevant organizations. </p><p><a rel="nofollow" class="external text" href="https://docs.google.com/forms/d/1HgdA6yBIdQ567ydHjxc5RLo66p9ihwah4kML0vCdR5A/edit">GHQ12 For maritime students</a> </p><p><a rel="nofollow" class="external text" href="https://docs.google.com/forms/d/1rSGz_J7VuZfV8jT9gHSFVcgQNqt2_VfPCFvhtvHR6LY/edit">GHQ12 For seafarers and practicants</a> </p> <div class="mw-heading mw-heading2"><h2 id="Long-term_follow-up_of_the_cohort">Long-term follow-up of the cohort</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=15" title="Edit section: Long-term follow-up of the cohort" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=15" title="Edit section's source code: Long-term follow-up of the cohort"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>After a successful baseline study, follow-up will be done in 1-4-year intervals of the same participants. A low participation rate can be a problem. Further, the aim is to collaborate with other countries. Iceland that have shown interest for the same type of study. An identical questionnaire will be used with the possibility to compare between the countries. </p> <div class="mw-heading mw-heading2"><h2 id="Data_processing">Data processing</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=16" title="Edit section: Data processing" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=16" title="Edit section's source code: Data processing"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Data is transferred to electronic processing during the investigation. Standardized statistical methods will be used using the latest data processing SPSS program. Data will be handled under strict confidentiality in an anonymous form. All data will be stored in a special database to use data up following studies later. The current legislation is complied with. </p> <div class="mw-heading mw-heading2"><h2 id="Data_analysis">Data analysis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=17" title="Edit section: Data analysis" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=17" title="Edit section's source code: Data analysis"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Each of the Goldberg’s General Health Questionnaire (GHQ12) items has four answer options: 1) more than usual, 2) as usual, 3) less than usual, and 4) much less than usual describing mood states. Using the Likert code method 0-1-2-3 gives a total score range of 0–36. The Likert sum scores were classified as 0–14 (no problems), 15–19 (starting problems), and 19–36 (serious problems). Analyses of the Likert scores can be divided into two groups: group 1: Likert score 0–14 no problems, (no action needed) and group 2: Likert score 15–19 starting problems (included 2 with Likert score 20–36: serious problem).<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Cut-off-point of Likert scores for the GHQ-12 has been proposed in mental health studies of working people. The optimal cut-off points that can serve as a tool for identifying persons with a mental disorder were established at the level of 2/3 points for GHQ-12 <sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The explanation is that 2/3 of maximum scores = 36 in the Likert code method 0-1-2-3 with a cut-off point of 24. Lundin et al. y Pesel et al. estimated the beginning of problems at 12+ and 14+, respectively<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> <sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> Excel methods to recode the questions <sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Ethical_requirements">Ethical requirements</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=18" title="Edit section: Ethical requirements" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=18" title="Edit section's source code: Ethical requirements"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since the study does not involve blood sampling, and since participation in the study is completely voluntary after informed consent, the study does not involve ethical problems. All data are treated according to the Act on the duty of confidentiality, and the guidelines for good epidemiological practice will be followed. The participants' anonymity will be ensured in all ways and this will be apparent from the project description and the form. It will be ensured that the electronic form is locked so that the information cannot be seen by anyone other than the researchers. <a class="external text" href="https://en.wikiversity.org/wiki/Maritime_Health_Research_and_Education-NET#Ethical_requirements">More detailed information</a> <a rel="nofollow" class="external text" href="https://www.sdu.dk/da/om_sdu/fakulteterne/sundhedsvidenskab/om_sund/gdpr_sund">SDU Guide for data safety </a> </p> <div class="mw-heading mw-heading2"><h2 id="Dissemination_of_results">Dissemination of results</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=19" title="Edit section: Dissemination of results" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=19" title="Edit section's source code: Dissemination of results"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The students finish his/her Thesis which will also be handed over to the UMIP. The results will also be presented in the Maritime News and at conferences and be available on relevant websites from e.g. In case the student wants to go further support to write a scientific article will be given. </p> <div class="mw-heading mw-heading2"><h2 id="Work_plan">Work plan</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=20" title="Edit section: Work plan" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=20" title="Edit section's source code: Work plan"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <ol><li>Agreement with the universities and the students</li> <li>Questionnaire translations and development</li> <li>Pilot test</li> <li>Mail lists</li> <li>Mail send out with link to the questionnaire</li> <li>Data analysed and tables ready</li> <li>Thesis prepared (and possibly an article)</li> <li>Prevention plan</li></ol> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&veaction=edit&section=21" title="Edit section: References" class="mw-editsection-visualeditor"><span>edit</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&action=edit&section=21" title="Edit section's source code: References"><span>edit source</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r2661605">.mw-parser-output .reflist{font-size:90%;margin-bottom:0.5em;list-style-type:decimal}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><a href="#cite_ref-1">↑</a></span> <span class="reference-text">Jensen H-J, Oldenburg M. Training seafarers to deal with multicultural crew members and stress on board. International maritime health. 2020;71(3):174–180. </span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><a href="#cite_ref-2">↑</a></span> <span class="reference-text"> <a rel="nofollow" class="external free" href="https://ec.europa.eu/health/sites/health/files/mental_health/docs/2017_mh_schools_en.pdf">https://ec.europa.eu/health/sites/health/files/mental_health/docs/2017_mh_schools_en.pdf</a> </span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><a href="#cite_ref-3">↑</a></span> <span class="reference-text"> <a rel="nofollow" class="external text" href="https://learningportal.iiep.unesco.org/en/library/the-who-health-promoting-school-framework-for-improving-the-health-and-well-being-of?back_url=/en/library/search/occupational%20health%20research">The WHO health-promoting school-framework for improving the health and well being</a></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><a href="#cite_ref-4">↑</a></span> <span class="reference-text"><a rel="nofollow" class="external free" href="https://pubmed.ncbi.nlm.nih.gov/24737131/">https://pubmed.ncbi.nlm.nih.gov/24737131/</a></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><a href="#cite_ref-5">↑</a></span> <span class="reference-text"><a rel="nofollow" class="external free" href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1360-y">https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1360-y</a></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><a href="#cite_ref-6">↑</a></span> <span class="reference-text">Hatami, Ali, Shahram Vosoughi, Agha F. Hosseini, and Hossein Ebrahimi. ‘Effect of Co-Driver on Job Content and Depression of Truck Drivers’. Safety and Health at Work 10, no. 1 (March 2019): 75–79 <a rel="nofollow" class="external free" href="https://doi.org/10.1016/j.shaw.2018.06.001">https://doi.org/10.1016/j.shaw.2018.06.001</a></span> </li> <li id="cite_note-7"><span class="mw-cite-backlink"><a href="#cite_ref-7">↑</a></span> <span class="reference-text">Kumar, Shailesh, Simon Hatcher, and Peter Huggard. ‘Burnout in Psychiatrists: An Etiological Model’. International Journal of Psychiatry in Medicine 35, no. 4 (2005): 405–16. <a rel="nofollow" class="external free" href="https://doi.org/10.2190/8XWB-AJF4-KPRR-LWMF">https://doi.org/10.2190/8XWB-AJF4-KPRR-LWMF</a> </span> </li> <li id="cite_note-8"><span class="mw-cite-backlink"><a href="#cite_ref-8">↑</a></span> <span class="reference-text">Danasekaran, Raja, and Ravivarman Govindasamy. ‘Better Psychosocial Work Environment: For Well-Being of the Worker and the Organization’. Indian Journal of Occupational and Environmental Medicine 23, no. 1 (2019): 57–58. <a rel="nofollow" class="external free" href="https://doi.org/10.4103/ijoem.IJOEM_183_18">https://doi.org/10.4103/ijoem.IJOEM_183_18</a> </span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><a href="#cite_ref-9">↑</a></span> <span class="reference-text">Johannes Siegrist European archives of psychiatry and clinical neuroscience 258 (5), 115-119, 2008</span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><a href="#cite_ref-10">↑</a></span> <span class="reference-text">Giuliano Pesel, Maria Luisa Canals, Matteo Sandrin, Olaf Jensen Wellbeing of a selection of seafarers in Eastern Adriatic Sea during the COVID-19 pandemic 2020 Giuliano Pesel, Maria Luisa Canals, Matteo Sandrin, Olaf Jensen DOI: 10.5603/IMH.2020.0033·Pubmed: 33001430·International Maritime Health 2020;71(3):184-190 <a rel="nofollow" class="external free" href="https://journals.viamedica.pl/international_maritime_health/article/view/IMH.2020.0033">https://journals.viamedica.pl/international_maritime_health/article/view/IMH.2020.0033</a></span> </li> <li id="cite_note-11"><span class="mw-cite-backlink"><a href="#cite_ref-11">↑</a></span> <span class="reference-text">Makowska, Zofia, Dorota Meretz, Agnieszka Mościcka, and Wojciech Kolasa. ‘The Validity of General Health Questionnaires, GHQ-12, and GHQ-28, in Mental Health Studies of Working People’. International Journal of Occupational Medicine and Environmental Health 15, no. 4 (2002): 353–62 </span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><a href="#cite_ref-12">↑</a></span> <span class="reference-text">Lundin, A., M. Hallgren, H. Theobald, C. Hellgren, and M. Torgén. ‘Validity of the 12-Item Version of the General Health Questionnaire in Detecting Depression in the General Population. Public Health 136 (July 2016): 66–74. <a rel="nofollow" class="external free" href="https://doi.org/10.1016/j.puhe.2016.03.005">https://doi.org/10.1016/j.puhe.2016.03.005</a>.</span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><a href="#cite_ref-13">↑</a></span> <span class="reference-text">Pesel, Giuliano, Maria Luisa Canals, Matteo Sandrin, and Olaf Jensen. ‘Wellbeing of a Selection of Seafarers in Eastern Adriatic Sea during the COVID-19 Pandemic 2020’. International Maritime Health 71, no. 3 (2020): 184–90. <a rel="nofollow" class="external free" href="https://doi.org/10.5603/IMH.2020.0033">https://doi.org/10.5603/IMH.2020.0033</a></span> </li> <li id="cite_note-14"><span class="mw-cite-backlink"><a href="#cite_ref-14">↑</a></span> <span class="reference-text"><a rel="nofollow" class="external free" href="https://www.dropbox.com/s/tvn59dnghigwby6/olafGHQ12%20%20Recode%20repsonses%20example.xlsx?dl=0">https://www.dropbox.com/s/tvn59dnghigwby6/olafGHQ12%20%20Recode%20repsonses%20example.xlsx?dl=0</a></span> </li> </ol></div></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikiversity.org/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&oldid=2583293">https://en.wikiversity.org/w/index.php?title=Maritime_Health_Research_and_Education-NET/Cohort_protocols/GHQ12_Cohort_protocol&oldid=2583293</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Special:Categories" title="Special:Categories">Category</a>: <ul><li><a href="/wiki/Category:Maritime_Health_Research_and_Education-NET" title="Category:Maritime Health Research and Education-NET">Maritime Health Research and Education-NET</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> This page was last edited on 25 November 2023, at 08:17.</li> <li id="footer-info-copyright">Text is available under the <a rel="nofollow" class="external text" href="//creativecommons.org/licenses/by-sa/4.0/">Creative Commons Attribution-ShareAlike License</a>; additional terms may apply. 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