Certification Process Research Articles

Mortality and causes of death in Serbia: redistribution of garbage codes to ischemic heart disease

Abstract Background Cardiovascular diseases are ranked as the number one cause of death in Serbia, and one-fifth of them present ischemic heart disease (IHD). However, the physicians certifying the cause of death have either not been adequately involved in how to complete a death certificate according to the current International Statistical Classification of Diseases (ICD-10) or due to a high level of administrative tasks sometimes fail to complete the process of death certification. That is why we aimed to investigate the garbage codes (GCs) and the effects of their redistribution on underlying cause of death (CoD) estimates for IHD for 2015 and 2020. Methods Data from Belgrade mortality statistics in 2015 and 2020 were used to describe the occurrence and redistribution of garbage codes (GCs), defined as unspecified or impossible causes of death. In order to redistribute GCs we observed the underlying, antecedent, immediate causes and other conditions that contributed to deaths. Redistribution was done by consulting GBD methodology for GC proportional redistribution. The ICD-10 code range for IHD is I20-I25. Results In Belgrade, 17% (4022/23663) and 20.9% (5818/27775) of the deaths were coded with a garbage code in 2015 and 2020, respectively. In 2015, 2102 deaths (10.7% of all well-defined CoD) were attributed to IHD, while in 2020, 1806 (8,2% of all well-defined CoD) deaths were attributed to IHD. Finally, we redistributed a total of 452 deaths (GC type 1 203.9, GC type 2 122.1 and GC type 3 126.2 deaths) and 572 deaths (GC type 1 250.1, GC type 2 110.9, GC type 3 210.7 and GC type 4 22) due to IHD in 2015 and 2020, respectively. These calculations indicate a total number of 2554 and 2378 deaths due to IHD in 2015 and 2020, respectively. Conclusions A more detailed analysis of local practices, as well as continuing medical education in the field of death certification, could be a step forward in the future process of decreasing the number of GCs. Key messages • Since the huge number of deaths was added to ischemic heart disease in 2015 and 2020, it is crucial to focus on a more reliable disease surveillance system including better coding practices. • A deep understanding of the garbage codes and their redistribution could significantly shape future decisions on factors contributing to ischemic heart diseases.

Chatbots in medicine: certification process and applied use case.

Chatbots are computer programs designed to engage in natural language conversations in an easy and understandable way. Their use has been accelerated recently with the advent of large language models. However, their application in medicine and healthcare has been limited due to concerns over data privacy, the risk of providing medical diagnoses, and ensuring regulatory and legal compliance. Medicine and healthcare could benefit from chatbots if their scope is carefully defined and if they are used appropriately and monitored long-term. The confIAnce chatbot, developed at the Geneva University Hospitals and the University of Geneva, is an informational tool aimed at providing simplified information to the general public about primary care and chronic diseases. In this paper, we describe the certification and regulatory aspects applicable to chatbots in healthcare, particularly in primary care medicine. We use the confIAnce chatbot as a case study to explore the definition and classification of a medical device and its application to chatbots, considering the applicable Swiss regulations and the European Union AI Act. Chatbots can be classified anywhere from non-medical devices (informational tools that do not handle patient data or provide recommendations for treatment or diagnosis) to Class III medical devices (high-risk tools capable of predicting potentially fatal events and enabling a pre-emptive medical intervention). Key considerations in the definition and certification process include defining the chatbot's scope, ensuring compliance with regulations, maintaining security and safety, and continuously evaluating performance, risks, and utility. A lexicon of relevant terms related to artificial intelligence in healthcare, medical devices, and regulatory frameworks is also presented in this paper. Chatbots hold potential for both patients and healthcare professionals, provided that their scope of practice is clearly defined, and that they comply with regulatory requirements. This review aims to provide transparency by outlining the steps required for certification and regulatory compliance, making it valuable for healthcare professionals, scientists, developers, and patients.

Sustainability and Strategic Positioning in Hydroponic Production

Objective: This study analyzes the strategic positioning of a family farming company, exploring intersections in support of the certification process for the organic production of leafy vegetables. Theoretical Framework: We adopt a qualitative approach to achieve the objective through a case study on a farm in Minas Gerais/Brazil. We present details on hydroponics, the sustainability tripod, and strategic planning. Method: We presented an analysis of strategic planning. We applied case studies and bibliographic research. We employed a qualitative approach based on information obtained through interviews and in-loco observations. Results and Discussion: The results present the analysis of the SWOT matrix that compares the internal conditions of the organization with market conditions. The results highlighted the potential of the company under investigation. The offensive capacity demonstrates excellent conditions for taking advantage of opportunities. The defensive capacity reported the vulnerability to repel threats. Research Implications: This case study highlights the potential of analyzing strategic positioning. By applying the SWOT matrix and calculating strategic positioning, a significant positive value that attests to the offensive capacity in relation to the external environment was observed. Originality/Value: This study discusses the applicability of strategic positioning analysis for hydroponic companie sthrough sustainability actions. The interest in this product is widely known and highlights the relevance of studies to foster the evolution of strategic management in this segment.

DETERMINANTS INFLUENCING MADEIRA ISLAND'S SUSTAINABLE DEVELOPMENT POLICIES AS AN ECO-TOURISM DESTINATION: AN EMPIRICAL STUDY

Objective: Based on the standards of Global Sustainable Tourism Council and the participants' experiences at destination, the current study aims to reflect and survey among visitors to Madeira Island about the primary challenges to be taken into consideration for the development of sustainable policies for the tourist destination. Method: 1136 valid questionnaires were collected and statistical treatment was carried out. In order to create value, replicate it in the economy, and improve the well-being of both residents and visitors to the Destination, all parties involved in the Sustainable Destination certification process. Results and Discussion: The findings hold significance for an enhanced comprehension of the phenomena intrinsic to the Madeira Eco-Tourist Destination. Research Implications: The practical implications of the research were to recommend ways in which political decision-makers and companies in the tourism sector can improve their performance in the process of certifying the Madeira Islands destination as an Eco-Tourism destination with sustainability concerns. The research is relevant to the enrichment of literature at the level of Portuguese-speaking academia, in the panorama of global and island studies, particularly in the development of socioeconomic policies for sustainable tourism. Originality/Value: This study contributes to the growing body of knowledge on the border between the management of tourism destination certification projects based on sustainability and tourism innovation/promotion and can contribute something new for both professionals and policy makers in the formulation environment. of sustainable development policies for destinations.

Municipal Waste Treatment: Climate Change Mitigation Impacts and Carbon Credit Market Effects

Objective: Analyze the feasibility of proposing a comprehensive methodology for inventorying greenhouse gas (GHG) emissions from urban waste, with the goal of enhancing the attractiveness of carbon credits and demonstrating their impacts on climate mitigation. Theoretical Framework: The research is grounded in theories related to climate change, the circular economy, and urban waste management. Global warming is discussed through the works of authors such as David Wallace-Wells and José Goldemberg, alongside concepts from the GHG Protocol and Life Cycle Assessment (LCA). Method: The methodology involves a bibliographic review, document analysis, and exploratory research using secondary and qualitative data. Scientific articles and documents from organizations such as the IPCC and EMBRAPA, among other academic sources, were utilized. Results and Discussion: The research emphasizes that proper management of urban waste, aligned with the principles of the circular economy, can substantially reduce GHG emissions. "Zero Waste" projects are analyzed as viable alternatives for mitigating emissions and obtaining carbon credits. The Life Cycle Assessment (LCA) of products is identified as crucial for inventorying emissions across various stages of the life cycle, thereby facilitating the certification process for carbon credits. Research Implications: The proposed methodology can encourage new investments in recycling and waste reuse, as well as support the establishment of waste treatment units that maximize resource recovery and minimize environmental impacts.Originality: This study contributes to the literature by presenting an innovative approach to the management of urban waste and carbon credits, highlighting the importance of LCA in certifying reduced emissions. Originality: This study contributes to the existing literature by introducing an innovative approach to urban waste management and carbon credits, underscoring the importance of LCA in the certification of reduced emissions.

Organic Farming for Residue-Free Production

Organic farming has emerged as a sustainable agricultural practice aimed at producing food without synthetic chemicals, pesticides, and genetically modified organisms (GMOs). This approach promotes biodiversity, soil health, and environmental sustainability while ensuring residue-free food production. The key principles of organic farming include crop rotation, composting, natural pest management, and the use of organic inputs such as manure and biological controls. These practices not only enhance soil fertility and biodiversity but also contribute to mitigating climate change by sequestering carbon in soils. Residue-free production in organic farming is achieved through rigorous adherence to organic standards and certification processes. Organic certification ensures that farmers comply with strict regulations regarding inputs, practices, and traceability throughout the production chain. Consumers increasingly prefer organic products due to concerns about chemical residues in food and their potential impact on health. Organic farming promotes transparency and consumer trust by offering products that are free from synthetic pesticides, herbicides, and fertilizers. The global market for organic products continues to expand, driven by growing consumer awareness and demand for healthier and environmentally friendly food options. Organic farming presents opportunities for farmers to access premium markets, improve farm profitability, and contribute to sustainable agriculture. However, challenges such as certification costs, market access barriers, and competition with conventional agriculture remain significant. Future research and development in organic farming are crucial to addressing these challenges and enhancing the scalability and efficiency of residue-free production. Innovations in organic pest management, soil health management, and sustainable agriculture practices will further support the growth of organic farming worldwide. Overall, organic farming stands as a promising solution for residue-free food production, promoting human health, environmental stewardship, and sustainable development in agriculture.

Forest certification and economic insights: a European perspective

In recent years, there has been an increasing demand for forest certification and certified forest products in Europe. This trend is related to major worldwide challenges, such as the need to decarbonize the economy and mitigate climate change but also social and consumer demands for wider fair trade. However, whether forest certification influences economic valorization in forestry remains a question. The aim of this study is to analyze forest certification levels across Europe and identify potential relationships between the level of certification in forest areas and relevant economic indicators at country level. This study collected openly available data on total and certified forest areas, economic indicators, and environmental indicators for 28 European countries and explored the correlation between certified forest areas and economic performance in the forestry sector. Findings show that forest certification can significantly improve the economic performance of European forests. It has a more pronounced positive effect on economic incomes than on costs’ reduction. While certification costs do rise with the extent of forest area, they tend to stabilize at larger scales, suggesting that the certification process is economically sustainable and scale is relevant. Czechia and the Netherlands stand out for having the highest net values added related to forest certification, reflecting an effective economic exploration of forest resources. This study offers new perspectives to natural and social scientists, as well as to industry and policy makers, by proving contextualized data to support decision making. Additionally, it provides hints for further studies and policy guidelines on sustainable development and the impact of forest certification schemes.

Delivering a pilot Institution Wide Language Programme (IWLP) at an Irish University: teachers’ perspectives

Abstract This paper analyses the language educator’s experience of delivering an Institution-Wide Language Programme (IWLP) in an Irish University. It uses a focus group to explore the experiences of six International Language Tutors who delivered modules on a pilot IWLP between 2021 and 2024. The findings indicate that designing and delivering the programme was a predominantly rewarding experience for the tutors involved. Positive aspects included engagement levels among students who completed the programme, the freedom to design, deliver and assess modules in a flexible and innovative manner, and the supportive nature of the tutor team. Negative aspects relate to policy issues concerning student eligibility for the programme, operational issues such as (de-)registration, attendance and attrition rates, and misalignment between student and module proficiency levels. Recommendations relate to IWLP design and administration as well as to supports for IWLP language educators. They include the use of hybrid teaching as standard, the opening of IWLPs to all staff and students (using caps on numbers and waiting lists), clear communication to potential participants in relation to the relationship between IWLP language modules and main degrees reflected in simplified registration, deregistration and certification processes, the provision of training in hybrid design and delivery of language modules as well as of appropriate teaching infrastructure, and full integration of the IWLP teaching team into institutional support structures.

Analysis of implementation factors of management systems – case of the Republic of Croatia

Management systems can serve as a foundation for more efficient and effective organizational management. By certifying their management system, an organization demonstrates its commitment to excellence and focus on meeting interested parties’ requirements. However, certification is determined by the decision of the organization’s management, which can be influenced by various factors such as the organization’s size, the market in which it operates, market opportunities, availability of financial resources, the organization’s product portfolio, and more. Therefore, the aim of this research is to identify the factors that influence the management’s decision to initiate the certification process and certify the management system. The research was conducted on a sample of 320 business entities registered in the Republic of Croatia. The research instrument was a questionnaire, and the research results can be used to compare different countries in the Western Balkans region or European Union member states.

Certified B Corps: An Examination of a Standard Based Approach to Stakeholder Governance

In 2015, B Corp certification was launched in the UK. Since then, over 1,200 companies have adopted certified B Corps status. Most certified B Corps in the UK are small and medium-sized, with SMEs accounting for 99.9% of businesses in the UK. The B Corp movement seeks to change the economic system from a shareholder capitalism to a stakeholder economy. Certified B Corps adopt a stakeholder-driven mode towards ‘high standards of social and environmental performance, accountability and transparency.’ The article explores the growth of the B Corp movement, issues around its standards, certification process, including the legal requirement, transparency, and governance. It examines the effectiveness of this standard-based approach for stakeholder governance. It argues that the certified B Corp creates an avenue for stakeholder governance. However, to fully realise the shift towards stakeholder governance, there is a need for greater work towards achieving accountability for all key stakeholders identified as shareholders, workers, community, environment, and customers.

Standardization Efforts for Ayam Goreng Kalasan Industry Cluster Through a Partnership Between the University and Local Government to Maintain its Local Wisdom

A community service partnership is carried out between a universityand a local government to standardize processes and products produced by theAyam Goreng Kalasan industry cluster. Efforts are made through a series offocused discussion activities, knowledge sharing, and material provision, as wellas training and mentoring on aspects of standardization, product diversification,and promotion toward marketing with a broader scope. The first three stageswere carried out with the involvement of local government. The results ofthe community service implementation were measured using a comparison ofknowledge of business actors before and after the implementation of the activities.A total of 31 business actors, as members of the Ayam Goreng Kalasan MajuMakmur industry cluster, have participated in this activity. Increased knowledgeis observed in all aspects: standardization, diversification, management, andmarketing. The collaboration between the university and the local government,therefore, can increase the participation of business actors, accelerate the requiredstandardization and certification process, and further increase the possibility ofsustainability of cluster business development.

Challenging and encouraging halal certification in handicraft MSMEs

Halal certification, a crucial aspect of the halal product industry in Indonesia, is mandatory for food and beverage products. However, awareness and understanding of halal certification remain low among Handicraft MSMEs (Micro, Small, and Medium Enterprises). This research explores the perceptions, understanding, awareness, and challenges Handicraft MSMEs face regarding halal certification. A qualitative approach with semi-structured interviews was employed as the data collection method, followed by NVivo software analysis. The results indicate that Handicraft MSMEs lack an understanding of the importance of halal certification and are unaware of the obligations and procedures involved. We identified insufficient socialization as a significant obstacle, underscoring the urgent need for more awareness campaigns and educational programs. The complexity of the certification process and lack of coordination among halal institutions are also significant obstacles. This research provides profound insights into the challenges and opportunities in implementing halal certification for Handicraft MSMEs, emphasizing the crucial role of the government in promoting and facilitating halal certification implementation for Handicraft MSMEs to support growth and competitiveness in the market. Keywords: Halal certification, Handicraft MSMEs, NVivo

Pediatric Dentistry Program Directors as stakeholders in the process of Board certification.

Board certification is an important credential for pediatric dentists to achieve for purposes of career advancement, hospital privileges, and reputation. The purpose of this pilot study was to assess the engagement of residency Program Directors (PDs) with the Board certification process in terms of criteria for clinical readiness, curriculum development, and value. An additional objective was to identify challenges and ways in which PDs may need support as they prepare residents for Board certification. Eighty-seven PDs were invited to participate in this study, out of which 32 agreed to participate (36% response rate). The study included a digital non-validated survey and verbal interviews. Digital and verbal survey results were analyzed using descriptive statistics. PDs had recurrent themes in their descriptions of clinical readiness, including information gathering, application of knowledge, and professional awareness. Half of the participants used the American Board of Pediatric Dentistry (ABPD) exam domains as a guideline in their curriculum development. Of the verbal interview participants (N=32), 30(94%) felt that Board certification was very important to their residents and program. Many barriers to successful completion of the Board exam were discussed, and a diverse array of suggestions were made for mechanisms to better support PDs as they prepare residents for Board certification. Board certification is valued by PDs and influences their criteria for clinical readiness. Increased engagement with the ABPD will facilitate better support for PDs and will enhance the consistency of training standards in residency programs.

Leveraging Digital Technologies for Carbon Footprint Tracking in Perennial Cultivations: A Case Study of Walnut Orchard Establishment in Central Greece

The present paper aims to quantify the carbon emissions associated with the establishment of 15 walnut orchards (“Juglans californica”) in the greater area of Magnisia, Greece, with the use of a carbon footprint tool interconnected to a Farm Management Information System. The data collection spanned the first five years following the planting of the trees, providing a comprehensive view of the emissions during this critical establishment phase. Over the five-year period examined (February 2019–December 2023), the results revealed net carbon emissions amounting to 13.71 tn CO2 eq ha−1, with the calculated emissions showing an increasing trend from the first year through the fifth year. Scope 1 (7.38 tn CO2 eq ha−1) and Scope 2 (3.71 tn CO2 eq ha−1) emissions emerged as the most significant, while irrigation (drip irrigation) and fertilizing practices were identified as the highest contributors to emissions. This study highlights the significance of using integrated digital tools for monitoring the performance of cultivations rather than standalone tools that are currently widely available. Integrated tools that incorporate various applications simplify data collection, encourage accurate record-keeping, and facilitate certification processes. By automating data entry and calculations, these tools reduce human error during agricultural carbon management and save time; thus, the integration of digital monitoring tools is vital in improving data accuracy, streamlining certification processes, and promoting eco-friendly practices, crucial for the evolving carbon market.

Psycho-Productive Skill Test Items Construction and Validation in Motor Vehicle Mechanic Work for State Wide Assessment in Technical Colleges

The technical colleges in Nigeria face challenges in assessing the psycho-productive skills of motor vehicle mechanic students due to a lack of standardized assessment tools. This study focused on the development and validation of psycho-productive multiple-choice skill tests (PMCST) for assessing the practical performances of technical college students in motor vehicle mechanic work across Ekiti and Ondo States. Adopting an instrumentation research design, instrumentation research design was considered appropriate because the study developed an instrument for assessment of practical skills of students. The study targeted a population of 350 National Technical Certificate (NTC) III students, encompassing three ability groups: 57 high, 201 average, and 92 low ability students. A draft copy of the PMCST, comprising 180 items, was generated and utilized as the instrument for assessment in five technical colleges across both states. Data analysis was performed using the split-half technique and Kudder-Richardson (K-R20), yielding a reliability coefficient of 0.84 for the test. Significant differences were found in the mean scores of the three ability groups. Among the recommendations arising from the study is the suggestion that examination bodies such as NABTEB, WAEC, and NECO integrate the PMCST into their certification processes for NTC students.

Toward a responsible future: recommendations for AI-enabled clinical decision support.

Integrating artificial intelligence (AI) in healthcare settings has the potential to benefit clinical decision-making. Addressing challenges such as ensuring trustworthiness, mitigating bias, and maintaining safety is paramount. The lack of established methodologies for pre- and post-deployment evaluation of AI tools regarding crucial attributes such as transparency, performance monitoring, and adverse event reporting makes this situation challenging. This paper aims to make practical suggestions for creating methods, rules, and guidelines to ensure that the development, testing, supervision, and use of AI in clinical decision support (CDS) systems are done well and safely for patients. In May 2023, the Division of Clinical Informatics at Beth Israel Deaconess Medical Center and the American Medical Informatics Association co-sponsored a working group on AI in healthcare. In August 2023, there were 4 webinars on AI topics and a 2-day workshop in September 2023 for consensus-building. The event included over 200 industry stakeholders, including clinicians, software developers, academics, ethicists, attorneys, government policy experts, scientists, and patients. The goal was to identify challenges associated with the trusted use of AI-enabled CDS in medical practice. Key issues were identified, and solutions were proposed through qualitative analysis and a 4-month iterative consensus process. Our work culminated in several key recommendations: (1) building safe and trustworthy systems; (2) developing validation, verification, and certification processes for AI-CDS systems; (3) providing a means of safety monitoring and reporting at the national level; and (4) ensuring that appropriate documentation and end-user training are provided. AI-enabled Clinical Decision Support (AI-CDS) systems promise to revolutionize healthcare decision-making, necessitating a comprehensive framework for their development, implementation, and regulation that emphasizes trustworthiness, transparency, and safety. This framework encompasses various aspects including model training, explainability, validation, certification, monitoring, and continuous evaluation, while also addressing challenges such as data privacy, fairness, and the need for regulatory oversight to ensure responsible integration of AI into clinical workflow. Achieving responsible AI-CDS systems requires a collective effort from many healthcare stakeholders. This involves implementing robust safety, monitoring, and transparency measures while fostering innovation. Future steps include testing and piloting proposed trust mechanisms, such as safety reporting protocols, and establishing best practice guidelines.

An introduction to the current state of standardization and certification on military AI applications

The main objective of this article is to provide an overview of the current state of development regarding certification and standardization efforts for Artificial Intelligence (AI) systems in military aviation. The incorporation of AI capabilities in the military holds the potential for significant strategic advantages in information and decision supremacy. However, AI also brings novel risks and safety considerations that existing certification processes are inadequate to address. Consequently, the need arises for the establishment of an entirely new certification framework, encompassing requirements and standardized processes tailored to the unique demands of AI safe-ty. During the development of such framework, the 7 High Level Requirements of the EU AI High Level Experts Group are taken as reference to develop the successive horizontal (cross-domain) and vertical (domain-specific) standards that would produce legal, robust and ethical AI. To facilitate the creation of a new AI certification framework in military aviation, a review has been done over traditional civil and military certification processes and the current AI certification progress under development, to present an overview of the key elements and processes involved. References from various levels (regulatory, industry, research) have been considered to provide an introduction to the prospective military AI certification framework.

Statutory reform of the death certification process in England and Wales

Statutory reform of the death certification process in England and Wales

2024 Updated EHRA core curriculum for physicians and allied professionals. A statement of the European Heart Rhythm Association (EHRA) of the ESC

Abstract Heart Rhythm management is a continuously evolving sub-speciality of cardiology. Every year, many physicians and allied professionals start and complete their training in Cardiac Implantable Electronic Devices (CIED) or Electrophysiology (EP) across the EHRA member countries. While this training ideally ends with an EHRA certification, the description of the learning pathway (what, how, when and where) through an EHRA Core Curriculum is also a prerequisite for a successful training. The first EHRA core curriculum for physicians was published in 2009. Due to the huge developments in the field of electrophysiology and device therapy, this document needed updating. In addition, a certification process for allied professionals has been introduced, as well as a recertification process and accreditation of EHRA recognised training centres. Learning pathways are more individualised now, with Objective Structured Assessment of Technical Skills (OSATS) to monitor learning progression of trainees. The 2024 Updated EHRA Core Curriculum for physicians and allied professionals describes, for both CIED and EP, the syllabus, OSATS, training program and certification and recertification for physicians and allied professionals and stresses the importance of continued medical education after certification. In addition, requirements for accreditation of training centres and trainers are given. Finally, suggested reading lists for CIED and EP are attached as online supplements.

To Avoid Accidents in Mines and Plants Adopt Safety System Standardization and Safety Management Certification Processes

No Abstract.