Search results for: clinical performance assessment

Authors: Ayelet Hersch, Corrine Serfaty, Sigal Portnoy

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Stroke survivors commonly report persistent fatigue and sleep disruptions during rehabilitation and post-recovery. While limited research has explored the impact of stroke on a patient's chronotype, there is a gap in understanding the differences in cognitive performance based on treatment timing. Study objectives: (a) To characterize the sleep chronotype in sub-acute post-stroke individuals. (b) Explore cognitive task performance differences during preferred and non-preferred hours. (c) Examine the relationships between sleep quality and cognitive performance. For this intra-subject study, twenty participants (mean age 60.2±8.6) post-first stroke (6-12 weeks post stroke) underwent assessments at preferred and non-preferred chronotypic times. The assessment included demographic surveys, the Munich Chronotype Questionnaire, Montreal Cognitive Assessment (MoCA), Rivermead Behavioral Memory Test (RBMT), a fatigue questionnaire, and 4-5 days of actigraphy (wrist-worn wGT3X-BT, ActiGraph) to record sleep characteristics. Four sleep quality indices were extracted from actigraphy wristwatch recordings: The average of total sleep time per day (minutes), the average number of awakenings during the sleep period per day, the efficiency of sleep (total hours of sleep per day divided by hours spent in bed per day, averaged across the days and presented as percentage), and the Wake after Sleep Onset (WASO) index, indicating the average number of minutes elapsed from the onset of sleep to the first awakening. Stroke survivors exhibited an earlier sleep chronotype post-injury compared to pre-injury. Enhanced attention, as indicated by higher RBMT scores, occurred during preferred hours. Specifically, 30% of the study participants demonstrated an elevation in their final scores during their preferred hours, transitioning from the category of "mild memory impairment" to "normal memory." However, no significant differences emerged in executive functions, attention tasks, and MoCA scores between preferred and non-preferred hours. The Wake After Sleep Onset (WASO) index correlated with MoCA/RBMT scores during preferred hours (r=0.53/0.51, p=0.021/0.027, respectively). The number of awakenings correlated with MoCA letter task performance during non-preferred hours (r=0.45, p=0.044). Enhanced attention during preferred hours suggests a potential relationship between chronotype and cognitive performance, highlighting the importance of personalized rehabilitation strategies in stroke care. Further exploration of these relationships could contribute to optimizing the timing of cognitive interventions for stroke survivors.

Keywords: sleep chronotype, chronobiology, circadian rhythm, rehabilitation timing

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Authors: Y. T. Chui, W. M. Au, L. Li

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Recently, wearable electronic textiles have been emerging in today’s market and were developed rapidly since, beside the needs for the clothing uses for leisure, fashion wear and personal protection, there also exist a high demand for the clothing to be capable for function in this electronic age, such as interactive interfaces, sensual being and tangible touch, social fabric, material witness and so on. With the requirements of wearable electronic textiles to be more comfortable, adorable, and easy caring, conductive yarn becomes one of the most important fundamental elements within the wearable electronic textile for interconnection between different functional units or creating a functional unit. The properties of conductive yarns from different companies can vary to a large extent. There are vitally important criteria for selecting the conductive yarns, which may directly affect its optimization, prospect, applicability and performance of the final garment. However, according to the literature review, few researches on conductive yarns on shelf focus on the assessment methods of conductive yarns for the scientific selection of material by a systematic way under different conditions. Therefore, in this study, direction of selecting high-quality conductive yarns is given. It is to test the stability and reliability of the conductive yarns according the problems industrialists would experience with the yarns during the every manufacturing process, in which, this assessment system can be classified into four stage. That is 1) Yarn stage, 2) Fabric stage, 3) Apparel stage and 4) End user stage. Several tests with clear experiment procedures and parameters are suggested to be carried out in each stage. This assessment method suggested that the optimal conducting yarns should be stable in property and resistant to various corrosions at every production stage or during using them. It is expected that this demonstration of assessment method can serve as a pilot study that assesses the stability of Ag/nylon yarns systematically at various conditions, i.e. during mass production with textile industry procedures, and from the consumer perspective. It aims to assist industrialists to understand the qualities and properties of conductive yarns and suggesting a few important parameters that they should be reminded of for the case of higher level of suitability, precision and controllability.

Keywords: applicability, assessment method, conductive yarn, wearable electronics

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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Authors: Phalaunnnaphat Siriwongs

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The classroom of the 21st century is an ever changing forum for new and innovative thoughts and ideas. With increasing technology and opportunity, students have rapid access to information that only decades ago would have taken weeks to obtain. Unfortunately, new techniques and technology are not the cure for the fundamental problems that have plagued the classroom ever since education was established. Class size has been an issue long debated in academia. While it is difficult to pin point an exact number, it is clear that in this case more does not mean better. By looking into the success and pitfalls of classroom size the true advantages of smaller classes will become clear. Previously, one class was comprised of 50 students. Being seventeen and eighteen- year- old students, sometimes it was quite difficult for them to stay focused. To help them understand and gain much knowledge, a researcher introduced “The Theory of Multiple Intelligence” and this, in fact, enabled students to learn according to their own learning preferences no matter how they were being taught. In this lesson, the researcher designed a cycle of learning activities involving all intelligences so that everyone had equal opportunities to learn.

Keywords: multiple intelligences, role play, performance assessment, formative assessment

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Authors: Eun-Chan Kim, Jeong-Hwan Oh, Seung-Guk Lee

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Billions of tones of ballast water including various aquatic organisms are being carried around the world by ships. When the ballast water is discharged into new environments, some aquatic organisms discharged with ballast water may become invasive and severely disrupt the native ecology. Thus, International Maritime Organization (IMO) adopted the Ballast Water Management Convention in 2004. Regulation A-4 of the convention states that a government in waters under their jurisdiction may grant exemptions to any requirements to ballast water management, but only when they are granted to a ship or ships on a voyage or voyages between specified ports or locations, or to a ship which operates exclusively between specified ports or locations. In order to grant exemptions, risk assessment should be conducted based on the guidelines for risk assessment developed by the IMO. For the risk assessment, it is essential to collect the relevant information and establish a database system. This paper studies the database system for ballast water risk assessment. This database consists of the shipping database, ballast water database, port environment database and species database. The shipping database has been established based on the data collected from the port management information system of Korea Government. For the ballast water database, ballast water discharge has only been estimated by the loading/unloading of the cargoes as the convention has not come into effect yet. The port environment database and species database are being established based on the reference documents, and existing and newly collected monitoring data. This database system has been approved to be a useful system, capable of appropriately analyzing the risk assessment in the all ports of Korea.

Keywords: ballast water, IMO, risk assessment, shipping, environment, species

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Authors: Reza Mohammadzadeh

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The major challenges in geotechnical engineering in underground spaces arise from uncertainties and different probabilities. The collection, collation, and collaboration of existing data to incorporate them in analysis and design for given prospect evaluation would be a reliable, practical problem solving method under uncertainty. Machine learning (ML) is a subfield of artificial intelligence in statistical science which applies different techniques (e.g., Regression, neural networks, support vector machines, decision trees, random forests, genetic programming, etc.) on data to automatically learn and improve from them without being explicitly programmed and make decisions and predictions. In this paper, a conceptual database schema of geotechnical risks in underground coal mining based on a cloud system architecture has been designed. A new approach of risk assessment using a three-dimensional risk matrix supported by the level of knowledge (LoK) has been proposed in this model. Subsequently, the model workflow methodology stages have been described. In order to train data and LoK models deployment, an ML platform has been implemented. IBM Watson Studio, as a leading data science tool and data-driven cloud integration ML platform, is employed in this study. As a Use case, a data set of geotechnical hazards and risk assessment in underground coal mining were prepared to demonstrate the performance of the model, and accordingly, the results have been outlined.

Keywords: data model, geotechnical risks, machine learning, underground coal mining

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Authors: Diane Ghanem, Oscar Covarrubias, Michael Raad, Dawn LaPorte, Babar Shafiq

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Introduction: Standardized exams have long been considered a cornerstone in measuring cognitive competency and academic achievement. Their fixed nature and predetermined scoring methods offer a consistent yardstick for gauging intellectual acumen across diverse demographics. Consequently, the performance of artificial intelligence (AI) in this context presents a rich, yet unexplored terrain for quantifying AI's understanding of complex cognitive tasks and simulating human-like problem-solving skills. Publicly available AI language models such as ChatGPT have demonstrated utility in text generation and even problem-solving when provided with clear instructions. Amidst this transformative shift, the aim of this study is to assess ChatGPT’s performance on the orthopaedic surgery in-training examination (OITE). Methods: All 213 OITE 2021 web-based questions were retrieved from the AAOS-ResStudy website. Two independent reviewers copied and pasted the questions and response options into ChatGPT Plus (version 4.0) and recorded the generated answers. All media-containing questions were flagged and carefully examined. Twelve OITE media-containing questions that relied purely on images (clinical pictures, radiographs, MRIs, CT scans) and could not be rationalized from the clinical presentation were excluded. Cohen’s Kappa coefficient was used to examine the agreement of ChatGPT-generated responses between reviewers. Descriptive statistics were used to summarize the performance (% correct) of ChatGPT Plus. The 2021 norm table was used to compare ChatGPT Plus’ performance on the OITE to national orthopaedic surgery residents in that same year. Results: A total of 201 were evaluated by ChatGPT Plus. Excellent agreement was observed between raters for the 201 ChatGPT-generated responses, with a Cohen’s Kappa coefficient of 0.947. 45.8% (92/201) were media-containing questions. ChatGPT had an average overall score of 61.2% (123/201). Its score was 64.2% (70/109) on non-media questions. When compared to the performance of all national orthopaedic surgery residents in 2021, ChatGPT Plus performed at the level of an average PGY3. Discussion: ChatGPT Plus is able to pass the OITE with a satisfactory overall score of 61.2%, ranking at the level of third-year orthopaedic surgery residents. More importantly, it provided logical reasoning and justifications that may help residents grasp evidence-based information and improve their understanding of OITE cases and general orthopaedic principles. With further improvements, AI language models, such as ChatGPT, may become valuable interactive learning tools in resident education, although further studies are still needed to examine their efficacy and impact on long-term learning and OITE/ABOS performance.

Keywords: artificial intelligence, ChatGPT, orthopaedic in-training examination, OITE, orthopedic surgery, standardized testing

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Authors: Mehrnoosh Pirhayati

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In this study, the researcher tried to propose a model of Translation Criticism (TC) regarding the phenomenon of Translation Quality Assessment (TQA). With changing the general view on re/writing as an illegal act, the researcher defined a scale for the act of translation and determined the redline of translation with other products. This research attempts to show TC as a related phenomenon to TQA. This study shows that TQA with using the rules and factors of TC as depicted in both product-oriented analysis and process-oriented analysis, determines the orientation or the level of the quality of translation. This study also depicts that TC, regarding TQA’s perspective, reveals the aim of the translation of original text and the root of ideological manipulation and re/writing. On the other hand, this study stresses the existence of a direct relationship between the linguistic materials and semiotic codes of a text or book. This study can be fruitful for translators, scholars, translation criticizers, and translation quality assessors, and also it is applicable in the area of pedagogy.

Keywords: a model of translation criticism, a model of translation quality assessment, critical discourse analysis (CDA), re/writing, translation criticism (TC), translation quality assessment (TQA)

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Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

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The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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Authors: Dragan Kljajic, Nikola Djuric, Karolina Kasas-Lazetic, Danka Antic

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Wireless communications have been expanded very fast in recent decades. This technology relies on an extensive network of base stations and antennas, using radio frequency signals to transmit information. Devices that use wireless communication, while offering various services, basically act as sources of non-ionizing electromagnetic fields (EMF). Such devices are permanently present in the human vicinity and almost constantly radiate, causing EMF pollution of the environment. This fact has initiated development of modern systems for observation of the EMF pollution, as well as for risk assessment. This paper presents the Serbian electromagnetic field monitoring network – SEMONT, designed for automated, remote and continuous broadband monitoring of EMF in the environment. Measurement results of the SEMONT monitoring at one of the test locations, within the main campus of the University of Novi Sad, are presented and discussed, along with corresponding exposure assessment of the general population, regarding the Serbian legislation.

Keywords: EMF monitoring, exposure assessment, sensor nodes, wireless network

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Authors: Adhila Sandra Devy, Evangeline Syalomita Silitonga

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The landscape of corporate governance and accountability has led to the emergence of Integrated Reporting (IR) in response to the shortcomings of traditional reporting frameworks. Developed by The International Integrated Reporting Council (IIRC), IR aims to offer stakeholders a comprehensive view of a company’s performance by integrating financial and non-financial disclosures. This study analyzes literature on Integrated Reporting and Corporate Financial Performance from 2013 to 2024, employing a descriptive analysis methodology. 31 relevant articles were gathered from various sources, indicating a positive correlation between integrated reporting and financial performance, albeit without conclusive evidence of long-term impact.

Keywords: integrated reporting, corporate financial performance, corporate performance, firm performance, bibliometric analysis

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Authors: Su-Lien Liao

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Most of college students in Taiwan do not have sufficient English proficiency to express themselves in written English. Teachers spent a lot of time correcting students’ English writing, but the results are not satisfactory. This study aims to use blogs as a teaching and learning tool in written English. Before applying peer assessment, students should be trained to be good reviewers. The teacher starts the course by posting the error analysis of students’ first English composition on blogs as the comment models for students. Then the students will go through the process of drafting, composing, peer response and last revision on blogs. Evaluation Questionnaires and interviews will be conducted at the end of the course to see the impact and students’ perception for the course.

Keywords: blog, peer assessment, English writing, error analysis

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Authors: Matej Stritesky

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The research deals with the connection between the Schwartz Theory of Basic Values and the ethical principles in psychology, on which the meta-code of ethics the European Federation of Psychological Associations is based. The research focuses on ethically problematic situations in clinical psychology in the Czech Republic. Based on the analysis of papers that identified ethically problematic situations faced by clinical psychologists, a questionnaire of ethically problematic situations in clinical psychology (EPSCP) was created for the purposes of the research. The questionnaire was created to represent situations that correspond to the 4 principles on which the meta-code of ethics the European Federation of Psychological Associations is based. The questionnaire EPSCP consists of descriptions of 32 situations that respondents evaluate on a scale from 1 (psychologist's behaviour is ethically perfectly fine) to 10 (psychologist's behaviour is ethically completely unacceptable). The EPSCP questionnaire, together with Schwartz's PVQ questionnaire, will be presented to 60 psychology students. The relationship between principles in clinical psychology and the values on Schwartz´s value continuum will be described using multidimensional scaling. A positive correlation is assumed between the higher-order value of openness to change and problematic ethical situations related to the principle of integrity; a positive correlation between the value of the higher order of self-transcendence and the principle of respect and responsibility; a positive correlation between the value of the higher order of conservation and the principle of competence; and negative correlation between the value of the higher order of ego strengthening and sensitivity to ethically problematic situations. The research also includes an experimental part. The first half of the students are presented with the code of ethics of the Czech Association of Clinical Psychologists before completing the questionnaires, and to the second half of the students is the code of ethics presented after completing the questionnaires. In addition to reading the code of ethics, students describe the three rules of the code of ethics that they consider most important and state why they chose these rules. The output of the experimental part will be to determine whether the presentation of the code of ethics leads to greater sensitivity to ethically problematic situations.

Keywords: clinical psychology, ethically problematic situations in clinical psychology, ethical principles in psychology, Schwartz theory of basic values

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Authors: Juanling Lin

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The construction of urban parks is an important part of eco-city construction, and the intervention of big data provides a more scientific and rational platform for the assessment of urban parks by identifying and correcting the irrationality of urban park planning from the macroscopic level and then promoting the rational planning of urban parks. The study builds an urban park assessment system based on urban road network data and POI data, taking Futian District of Shenzhen as the research object, and utilizes the GIS geographic information system to assess the park system of Futian District in five aspects: park spatial distribution, accessibility, service capacity, demand, and supply-demand relationship. The urban park assessment system can effectively reflect the current situation of urban park construction and provide a useful exploration for realizing the rationality and fairness of urban park planning.

Keywords: urban parks, assessment system, POI, supply and demand

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Authors: Münevver Başman, Ezel Tavşancıl

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Making the right decisions about students depends on teachers’ use of the assessment and evaluation techniques effectively. In order to do that, teachers should have positive attitudes and adequate self-efficacy perception towards assessment and evaluation. The purpose of this study is to investigate relationship between self-efficacy perception and the attitudes of prospective teachers towards assessment and evaluation and what kind of differences these issues have in terms of a variety of demographic variables. The study group consisted of 277 prospective teachers who have been studying in different departments of Marmara University, Faculty of Education. In this study, ‘Personal Information Form’, ‘A Perceptual Scale for Measurement and Evaluation of Prospective Teachers Self-Efficacy in Education’ and ‘Attitudes toward Educational Measurement Inventory’ are applied. As a result, positive correlation was found between self-efficacy perceptions and the attitudes of prospective teachers towards assessment and evaluation. Considering different departments, there is a significant difference between the mean score of attitudes of prospective teachers and between the mean score of self-efficacy perceptions of them. However, considering variables of attending statistics class and the class types at the graduated high school, there is no significant difference between the mean score of attitudes of prospective teachers and between the mean score of self-efficacy perceptions of them.

Keywords: attitude, perception, prospective teacher, self-efficacy

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Authors: Mohammed Nishat, Ahmad Ghazali

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This study empirically examines the corporate governance and firm performance, and tries to evaluate the governance, ownership and control related variables which are hypothesized to affect on firms performance. This study tries to evaluate the effectiveness of corporate governance mechanism to achieve high level performance among companies listed on the Karachi Stock Exchange (KSE) over the period from 2005 to 2008. To measure the firm performance level this research uses three measures of performance; Return on assets (ROA), Return on Equity (ROE) and Tobin’s Q. To link the performance of firms with the corporate governance three categories of corporate governance variables are tested which includes governance, ownership and control related variables. Fixed effect regression model is used to test the link between corporate governance and firm performance for 267 KSE listed Pakistani firms. The result shows that corporate governance variables such as percentage block holding by individuals have positive impact on firm performance. When CEO is also the chairperson of board then it is found that firm performance is adversely affected. Also negative relationship is found between share held by insiders and performance of firm. Leverage has negative impact on the performance of the firm and firm size is positively related with the firms performance.

Keywords: corporate governance, performance, agency cost, Karachi stock market

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Authors: Saad M. Darwish

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Recently, software quality issues have come to be seen as important subject as we see an enormous growth of agencies involved in software industries. However,these agencies cannot guarantee the quality of their products, thus leaving users in uncertainties. Software certification is the extension of quality by means that quality needs to be measured prior to certification granting process. This research participates in solving the problem of software assessment by proposing a model for assessment and certification of software product that uses a fuzzy inference engine to integrate both of process–driven and application-driven quality assurance strategies. The key idea of the on hand model is to improve the compactness and the interpretability of the model’s fuzzy rules via employing an ant colony optimization algorithm (ACO), which tries to find good rules description by dint of compound rules initially expressed with traditional single rules. The model has been tested by case study and the results have demonstrated feasibility and practicability of the model in a real environment.

Keywords: optimization technique, quality assurance, software certification model, software assessment

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Authors: Daniel Martinez, Tim de Leeuw, Stefan Haefliger

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The challenges of managing a large and geographically dispersed R&D organization have been further increasing during the past years, concentrating on the leverage of a geo-graphically dispersed body of knowledge in an efficient and effective manner. In order to reduce complexity and improve performance, firms introduce product modularity as one key element for global R&D network teams to develop their products and projects in collaboration. However, empirical studies on the effects of product modularity on innovation performance are really scant. Furthermore, some researchers have suggested that product modularity promotes innovation performance, while others argue that it inhibits innovation performance. This research fills this gap by investigating the impact of product modularity on various dimensions of innovation performance, i.e. effectiveness and efficiency. By constructing the theoretical framework, this study suggests that that there is an inverted U-shaped relationship between product modularity and innovation performance. Moreover, this research work suggests that the optimum of innovation performance efficiency will be at a higher level than innovation performance effectiveness at a given product modularity level.

Keywords: modularity, innovation performance, networks, R&D, collaboration

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Authors: Julija Konstantinavičienė, Vlada Vitunskienė

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The role of sustainable biomass, including wood biomass, is becoming more important because of European Green Deal. The New EU Forest strategy is a flagship element of the European Green Deal and a key action on the EU biodiversity strategy for 2030. The first measure of this strategy is promoting sustainable forest management, including encouraging the sustainable use of wood-based resources. The first aim of this research was to develop and present a new approach to the concept of forest wood biomass potential in terms of sustainable development, distinguishing theoretical, technical and sustainable potential and detailing its constraints. The second aim was to prepare the methodology outline of sustainable forest wood biomass potential assessment and empirically check this methodology, considering economic, social and ecological constraints. The basic methodologies of the research: the review of research (with a combination of semi-systematic and integrative review methodologies), rapid assessment method and statistical data analysis. The developed methodology of assessment of forest wood potential in terms of sustainable development can be used in Lithuania and in other countries and will let us compare this potential a different time and spatial levels. The application of the methodology will be able to serve the development of new national strategies for the wood sector.

Keywords: assessment, constraints, forest wood biomass, methodology, potential, sustainability

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Justin A. Udie, Subhes C. Bhatthacharyya, Leticia Ozawa-Meida

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The impact of climate change is severe in the Niger Delta and critical oil and gas infrastructures are vulnerable. This is partly due to lack of specific impact assessment framework to assess impact indices on both existing and new infrastructures. The purpose of this paper is to develop a framework for the assessment of climate change impact on critical oil and gas infrastructure in the region. Comparative and documentary methods as well as analysis of frameworks were used to develop a flexible, integrated and conceptual four dimensional framework underpinning; 1. Scoping – the theoretical identification of inherent climate burdens, review of exposure, adaptive capacities and delineation of critical infrastructure; 2. Vulnerability assessment – presents a systematic procedure for the assessment of infrastructure vulnerability. It provides real time re-scoping, practical need for data collection, analysis and review. Physical examination of systems is encouraged to complement the scoped data and ascertain the level of exposure to relevant climate risks in the area; 3. New infrastructure – consider infrastructures that are still at developmental level. It seeks to suggest the inclusion of flexible adaptive capacities in original design of infrastructures in line with climate threats and projections; 4. The Mainstreaming Climate Impact Assessment into government’s environmental decision making approach. Though this framework is designed specifically for the estimation of exposure, adaptive capacities and criticality of vulnerable oil and gas infrastructures in the Niger Delta to climate burdens; it is recommended for researchers and experts as a first-hand generic and practicable tool which can be used for the assessment of other infrastructures perceived as critical and vulnerable. The paper does not provide further tools that synch into the methodological approach but presents pointers upon which a pragmatic methodology can be developed.

Keywords: adaptation, assessment, conceptual, climate, change, framework, vulnerability

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Authors: Amália S. Botter Fabbri

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This paper proposes the analysis of the Strategic Environmental Assessment (SEA) in relation to the three pillars of the sustainable development, highlighting its particular importance to combat climate change. Theoretical and practical examples from Europe show how SEA has been implemented under the SEA Directive in the recent years, while the Brazilian case study shows a situation in which no regulation on SEA was implemented, despite the strong demand for it, as revealed by past experiences and future planning needs. In the end, some aspects to the formulation of a SEA Act are suggested, in an attempt to contribute to a better Brazilian environmental governance in relation to the future plans, programmes and policies required to the reduction of greenhouse gases emissions.

Keywords: Brazil, climate change, Europe, strategic environmental assessment

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Authors: Ambalika Ekka

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In today’s world, the growing demand for urban built forms has resulted in the production and consumption of building materials i.e. embodied energy in building construction, leading to pollution and greenhouse gas (GHG) emissions. Therefore, new buildings will offer a unique opportunity to implement more energy efficient building without compromising on building performance of the building. Embodied energy of building materials forms major contribution to embodied energy in buildings. The paper results in an approach towards designing an energy efficient apartment building through embodied energy assessment. This paper discusses the trend of residential development in Rourkela, which includes three case studies of the contemporary houses, followed by architectural elements, number of storeys, predominant material use and plot sizes using primary data. It results in identification of predominant material used and other characteristics in urban area. Further, the embodied energy coefficients of various dominant building materials and alternative materials manufactured in Indian Industry is taken in consideration from secondary source i.e. literature study. The paper analyses the embodied energy by estimating materials and operational energy of proposed building followed by altering the specifications of the materials based on the building components i.e. walls, flooring, windows, insulation and roof through res build India software and comparison of different options is assessed with consideration of sustainable parameters. This paper results that autoclaved aerated concrete block only reaches the energy performance Index benchmark i.e. 69.35 kWh/m² yr i.e. by saving 4% of operational energy and as embodied energy has no particular index, out of all materials it has the highest EE 23206202.43  MJ.

Keywords: energy efficient, embodied energy, EPI, building materials

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Yassine Bouzouita, Oumaima Belghith, Cyrine Zitoun, Charles Bonneau

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Performance measurement framework (PMF) is an essential tool in any organization to assess the performance of its processes. It guides businesses to stay on track with their objectives and benchmark themselves from the market. With the growing trend of the digital transformation of business processes, led by innovations in artificial intelligence (AI) & Big Data applications, developing a mature system capable of capturing the impact of digital solutions across different industries became a necessity. Based on the conducted research, no such system has been developed in academia nor the industry. In this context, this paper covers a variety of methodologies on performance measurement, overviews the major AI and big data applications in the banking sector, and covers an exhaustive list of relevant metrics. Consequently, this paper is of interest to both researchers and practitioners. From an academic perspective, it offers a comparative analysis of the reviewed performance measurement frameworks. From an industry perspective, it offers exhaustive research, from market leaders, of the major applications of AI and Big Data technologies, across the different departments of an organization. Moreover, it suggests a standardized classification model with a well-defined structure of intelligent digital solutions. The aforementioned classification is mapped to a centralized library that contains an indexed collection of potential metrics for each application. This library is arranged in a manner that facilitates the rapid search and retrieval of relevant metrics. This proposed framework is meant to guide professionals in identifying the most appropriate AI and big data applications that should be adopted. Furthermore, it will help them meet their business objectives through understanding the potential impact of such solutions on the entire organization.

Keywords: AI and Big Data applications, impact assessment, metrics, performance measurement

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Khawaja A. Wahaj Wani, Aykut Erkal

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Pakistan's construction industry, a key player in economic development, has experienced remarkable growth. However, the surge in activities has been accompanied by dangerous working conditions, attributed to legislative gaps and flaws. Unhealthy construction practices, uncertain site conditions, and hazardous environments contribute to a concerning rate of injuries and fatalities. The principal aim of this research study is to undertake a thorough evaluation based on the assessment of the current situation of Health & Safety policies and the surveys performed by stakeholders of Pakistan with the aim of providing solution-centric methodologies for the enforcement of health and safety regulations within construction companies operating on project sites. Recognizing the pivotal role that the construction industry plays in bolstering a nation's economy, it is imperative to address the pressing need for heightened awareness among site engineers and laborers. The study adopts a robust approach, utilizing questionnaire surveys and interviews. As an exclusive investigative study, it encompasses all stakeholders: clients, consultants, contractors, and subcontractors. Targeting PEC-registered companies. Safety performance was assessed through the examination of sixty safety procedures using SPSS-18. A high Cronbach's alpha value of 0.958 ensures data reliability, and non-parametric tests were employed due to the non-normal distribution of data. The safety performance evaluation revealed significant insights. "Using Hoists and Cranes" and "Precautionary Measures (Shoring and Excavation)" exhibited commendable safety levels. Conversely, "Trainings on Safety" displayed a lower safety performance, alongside areas such as "Safety in Contract Documentation," "Meetings for Safety," and "Worker Participation," indicating room for improvement. These findings provide stakeholders with a detailed understanding of current safety measures within Pakistan's construction industry.

Keywords: construction industry, health and safety regulations, Pakistan, risk management

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Stéfani T. A. Dantas, Laura T. S. Takume, Bruna F. Rossi, Érika R. Bonsaglia, Ivana G. Castilho, José C. F. Pantoja, Ary Fernandes Júnior, Juliano L. Gonçalves, Marcos V. Santos, Rinaldo A. Mota, Vera L. M. Rall

Abstract:

Staphylococcus aureus is one of the main pathogens causing contagious bovine mastitis, being more frequently isolated from subclinical form, although the clinical form also occurs. Clinical mastitis cause visual signs, such as swelling, fever, hardening of the mammary gland, or any change in the characteristics of the milk. Considering the subclinical type, there are no visible signs in the animal nor changes in the milk. S. aureus has many important virulence factors for the establishment of its pathogenicity in animals, such as enterotoxins, which are also responsible for foodborne poisoning. Our objective is to perform a comparative analysis between 103 isolates of S. aureus, obtained from the milk of cows with clinical mastitis and 103 more, from subclinical type, in relation to the presence of these enterotoxins and verify if their presence plays an important role in the signs of illness. We will investigate all enterotoxins described till now, such as sea-see, seg-sez, sel26, sel 27, se01, and se02 (This study was approved by the Sao Paulo State University Animal Use Ethics Committee, No. 0136/2017). For the PCR assay, we used Illustra Bacteria Mini Spin Kit for bacterial DNA. At this moment, we have already tested sea-see, seg-ser, sew, and sex, and the results have already been submitted to Fisher Exact Probability Test or Chi-square Test. Considering the isolates obtained from clinical mastitis, the most frequent enterotoxins were selw (99%), selx (78%) and selh (50.5%), and sec, see, sej, sell, selp,and ser were absent. Among the subclinics, selw (82.5%) selm (15.5%) and selx (14.6%) were the most frequent, and sea-see, seg, sei-sel, sem-ser were absent. We have already observed statistically significant differences for seb, seg, seh, sei, selo, selu, selw and selx. Other interesting results were the low number of genes in each isolate from subclinical mastitis [0 genes: 14 (13.6%); 1 gene: 55 (53.4%); 2 genes: 33 (32%) or 3: 1 (0.97%)] compared to clinical isolates [1 gene: 5 (4.9%); 2 genes: 29 (28.1%); 3 genes: 38 (36.9%); 4 genes: 14 (13.6%); 5 genes: 5 (4.9%); 6 genes: 4 (3.9%); 7 genes: 5 (4.9%); 8 genes: 2 (1.9%) and 9 genes: 1 (1%)]. Based on these results, we can conclude that enterotoxins indeed play an important role in clinical signs in cattle with mastitis.

Keywords: mastitis, S. aureus, PCR, staphylococcal enterotoxin

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Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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