Program Evaluation Research Articles

Evaluation of the water quality monitoring program of Mountain Rivers located in a tropical protected atlantic Forest area (PARNASO, Brazil): are the impacts of the highway really assessed?

Road activities are recognized sources of pollution that affect the hydrochemistry of nearby water bodies. This study evaluated the Water Quality Monitoring Program in the Soberbo and Iconha rivers in the Guapi-Macacu watershed, which is affected by the BR-116 highway. The Rio-Teresópolis Concessionaire from 2009 to 2016 carried out quarterly sampling. The parameters analyzed were: temperature, pH, turbidity, settleable solids, DO, BOD, NO3-, NO2-, NH4+, PO4-3, total and thermotolerant coliforms, Fe, Ni, Cr and Zn. PO4-3, pH, BOD and thermotolerant coliforms sometimes exceed the freshwater limits set by the National Environment Council (CONAMA 357/05, 2005). However, these values did not change the classification of "good" according to the water quality index used by the Brazilian environmental authorities for river waters. Precipitation was an important factor in understanding the hydrochemistry. Monthly precipitation ranged from 779.8 mm in January 2013 to 2.8 mm in July 2010. Temporal analysis using non-parametric tests showed significant differences (p < 0.05) in almost all parameters, indicating a strong influence of precipitation patterns on water quality. On a spatial scale, only coliform was found to differ between rivers (p < 0.01), suggesting an anthropogenic influence. Principal component analysis showed that chemical weathering and mechanical erosion processes predominated in both rivers (PC1: Soberbo River - 20.3%; Iconha River - 26.7%). Rainfall was identified as a secondary factor associated with coliforms and NH4+, especially in the Iconha River (PC2: Soberbo River-10.8%; Iconha River-11.9%), whose altitude indicated the atmospheric contribution of pollution from the metropolitan region of Rio de Janeiro. The reports of the Water Quality Monitoring Program were critically evaluated, resulting in recommendations aimed at optimizing their effectiveness and providing support for decision-making on the management of water resources in environmental protection areas.

Improving benign paroxysmal positional vertigo management in the emergency department: A longitudinal study post-GRACE-3.

Vertigo is a priority for training and decision support in emergency departments (ED). Benign paroxysmal positional vertigo (BPPV), though manageable at bedside, remains frequently underdiagnosed and undertreated. This study assessed the effectiveness of a two-tiered educational intervention on posterior and horizontal BPPV management in the ED setting. Longitudinal program evaluation study conducted over a year in a French ED, following GRACE-3 guidelines, involving patients with triggered episodic vestibular syndrome or brief vertigo without nystagmus. Two 6-month periods were compared: before (control cohort) and after (intervention cohort) an educational intervention of standardized training and an online decision support tool. The primary outcome was the prevalence of evidence-based BPPV diagnoses. Of the 382 patients included, 166 were in the control cohort (43.5%) and 216 were in the intervention cohort (56.5%). The intervention cohort had a higher rate of evidence-based BPPV diagnoses compared to the control cohort (38.0% vs. 16.9%), with an effect size of 21.1 (95% confidence interval [CI] 11.5-29.6, p < 0.0001). Canalith repositioning maneuvers were performed more frequently in the intervention cohort (90.2% vs. 57.7%), with an effect size of 33.1 (95% CI 13.2-53.1). Posttreatment tests showed a nonsignificant difference of 79.5% of intervention cohort patients testing negative versus 75.0% in the control cohort. ED length of stay was shorter in the intervention cohort (137 min vs. 247 min), with an effect size of -109.5 (95% CI -154.0 to -65.0). ED revisits within 1 month were similar (2.3% vs. 1.2%). During the intervention period, clinicians' satisfaction was correlated with the effectiveness of their clinical management. A standardized educational intervention demonstrated enhancing BPPV screening and improved evidence-based diagnosis, showing promise of more efficient treatment in the ED. Further multicenter studies are warranted to evaluate impacts on patient-reported outcomes and resource optimization.

Improving Project Time Estimation in Game Development: Rayleigh Distribution and Program Evaluation and Review Technique Approach

Improving Project Time Estimation in Game Development: Rayleigh Distribution and Program Evaluation and Review Technique Approach

Performance Evaluation of NAGRIC Community-Based Animal Breeding Program on Dairy Farming in Kikatsi Sub County Kiruhura District

Performance Evaluation of NAGRIC Community-Based Animal Breeding Program on Dairy Farming in Kikatsi Sub County Kiruhura District

Program Development for Enhancing Competencies of Vocational College Teachers in Mechatronics and Robotics under the Office of the Vocational Education Commission

The purposes of this research were to 1) study the components and indicators of teacher competency in Mechatronics and Robotics, 2) study the current states, desirable states, and the needs for teacher competency development in the Mechatronics and Robotics Department, 3) design and development of teacher competency-enhancing programs in Mechatronics and Robotics, and 4) study the results of implementing the teacher competency-enhancing program in the Mechatronics and Robotics Department. This research was research and development conducted in 4 phases following the research purposes. The results showed that 1) Components and indicators of teacher competency in Mechatronics and Robotics have 5 components and 36 indicators confirmed by experts are appropriate at the highest level. 2) The current state of teacher competency in the Mechatronics and Robotics Department overall is moderate, and desirable condition overall is at the highest level, The competency development methods consist of (1) Self-study (2) Training (3) Workshops (4) Study visits and (5) Practice in the workplace, and the priorities of the needs to develop competencies are (1) Self-development (2) Ethics and professional ethics of teachers (3) Learning measurement and evaluation (4) Curriculum administration, and learning management (5) Building relationships and cooperation with communities for learning management, respectively. 3) Teacher Competency-enhancing Program in the field of Mechatronics and Robotics consists of (1) Principles, (2) Objectives, (3) Models and methods for development, (4) Content and development activities, amounting to 5 modules, and (5) Evaluation. The program evaluation results by qualified experts are appropriateness, utility, and possibility at the highest level. 4) The results of implementing the teacher competency-enhancing program in Mechatronics and Robotics were found as follows: (1) Pre-development knowledge of teachers in Mechatronics and Robotics education showed an average score of 17.30 out of 30 (57.66%), while post-development knowledge increased to an average score of 26.30 out of 30 (87.67%). (2) Overall, teachers&amp;rsquo; competencies improved from a moderate level to the highest level after program implementation. (3) The satisfaction evaluation of program participants indicated the highest level of satisfaction in overall and each aspect.

“County lines” and child criminal exploitation in the UK: a secondary data analysis of focus groups with young people who attended a theatre-in-education programme

ABSTRACT The exploitation of young people in operations involving the transportation of illegal drugs across regions (known as “county lines”) is a rapidly growing problem facing schools, police forces and Children’s Services in the UK. Few school-based programmes focus on increasing young people’s awareness and understanding of exploitation in county lines. This study completed a secondary data analysis on focus group data collected as part of a Theatre-in-Education (TiE) programme evaluation, which aims to teach young people about types of exploitation through a performance and workshop approach. Young people aged between 13 and 15 years (n = 19) from two UK secondary schools took part in semi-structured focus groups. Data relating to criminal exploitation within county lines were thematically analysed. The analysis indicated that, whereas prior to the programme, participants had some awareness of child sexual exploitation in general, they had poor awareness of grooming and the occurrence of both sexual and criminal exploitation within county lines. The findings also revealed a lack of awareness and clarity surrounding blame and agency in child criminal and sexual exploitation. Future research should work towards providing effective activities within school-based programmes that aim to develop young people’s understanding and awareness of grooming in county lines. PRACTICE IMPACT STATEMENT Findings from this study highlight an urgent, unmet need for educational interventions for young people to raise awareness of both criminal and sexual exploitation in county lines. This includes education on grooming tactics used by perpetrators to help to prevent vulnerable young people becoming involved. Further research is needed on gender differences in criminal exploitation, including gang roles and outcomes, as well as perceptions of agency and blame in criminal exploitation.

Enhancing individual task performance and productivity: an ethnographic observational study of supported employment among social services clients in Finland

BackgroundThe purpose of the study was to investigate the various aspects of employees’ work environment, including their job characteristics; the level of support provided by supervisors, job coaches and coworkers; and their perceptions of job performance and productivity from the perspectives of both employees and supervisors in the context of sustainable employability in supported employment interventions. This study was part of the Finnish Work Ability Programme Evaluation Study (2020–2024).MethodsThis study is theoretically informed by the concepts of specific work ability and sustainable employability, as well as how health affects productivity at the task level—approach. The research is based on qualitative data obtained through ethnographic fieldwork, nonparticipating observing with interaction at work, which includes observing employed individuals in their workplaces. Additionally, we recorded discussions, took photos at work, and conducted interviews with supervisors and job coaches.ResultsThe main findings were that persons with disability or decreased work ability were employed in precarious low-productivity work, with limited opportunities for more sustainable employment. Several means from public employment services to decrease the employer’s personnel costs were used. The supervisors appeared to have a strong grasp of each employee’s task-specific productivity level. Supervisors had to adapt their usual tasks to provide extra support for employees, often focusing more on work performance. The role of coworkers and the work community as whole was also important. The personal support of job coaches during the employment phase was crucial, but their role in the workplace was unclear, especially to employers.ConclusionsTo strengthen sustainable careers, the matching of jobs and individuals should be promoted through closer and productivity-oriented cooperation with employers and work communities in vocational rehabilitation and re-employment. The chosen qualitative research strategy, ethnographic fieldwork at work and multi-perspective data collection provided new interpretations of the possibilities for sustainable employability using the Supported Employment method. From the perspectives of both enabling prolonged working careers for employees and providing a clear understanding of task-performance-based productivity to employers, there is a need for more microlevel data on what happens in work and workplaces, particularly the social mechanisms through which results are achieved.

Evaluation of the personality disorder positive outcomes programme (PDPOP) in general practice.

GPs and primary care services have been identified as crucial to the care of people with personality disorder. Individuals living with personality disorder frequently face stigma and difficulties when accessing healthcare. Primary care staff often describe feeling demoralised, incompetent, hurt or angry after difficult interactions with patients. To evaluate the effect of PDPOP training delivered to 10 GP practices in 2022-23. PDPOP is a co-produced training course aimed at all staff within GP surgeries to help teams, including administrative, reception and clinical staff, to feel confident and skilled when interacting with patients who may have personality disorder. The New World Kirkpatrick Model was used to evaluate the training, through questionnaires pre- training, post-training, at follow-up, and semi-structured interviews. Evaluation found that practice teams were highly satisfied with PDPOP training and found it relevant, engaging and useful. Results demonstrated that staff felt more confident and skilled when interacting with patients who may have personality disorder through use of the training's core concepts. Increased confidence in managing distress, crisis and participant's own emotions, was associated with reduced impact on staff at interview. Practices also demonstrated action taken post-training to reduce dependency on primary care services. By including lived-experience trainers and introducing core concepts, PDPOP has demonstrated a sustained positive impact on primary care teams. Further expansion of this type of training may help to increase the confidence of healthcare staff in delivering care to patients with personality disorder and similar complex emotional needs.

What Do We Know About Speech-Language-Hearing Practice in Vocal Care for Transgender People? A Scoping Review.

To systematically assess the current state of speech-language-hearing (SLH) practices in health services addressing vocal care for transgender individuals, aiming to identify key themes and gaps in the existing body of knowledge. This scoping review was based on the Joanna Briggs Institute manual and followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Extension for Scoping Reviews. It was registered with the Open Science Framework Open Source 10.17605/OSF.IO/BUCRG. Altogether, 1517 studies were found. After excluding duplicates and applying the eligibility criteria, 103 articles were chosen for the review. The studies addressed topics such as vocal training, case/experience reports, barriers to access services, SLH pathologists' and students' perception and knowledge about the transgender voice, evaluation of programs and services, transgender people's perception and knowledge about their own voice and SLH care, acoustic/auditory-perceptual evaluation, protocols, instruments, impacts of voice on quality of life, verbal and nonverbal communication, and hormone therapy and surgeries. The summary of the studies reflects the diversity of methods applied in research on transgender people's communication and voice, as well as the variety of topics. Despite the increasing publications on vocal care for transgender people, it is necessary to ensure the dissemination of evidence to support effective practices that recognize and enhance the diversity of this population. Literature data have promising SLH procedures and useful protocols to assess this population. However, they do not clearly indicate what the transgender population actually wants and needs. Furthermore, the study types have not progressed in a coherent order-that is, from preliminary studies to those with more robust methods. Thus, such knowledge may lack consolidation. Many answers to questions in both clinical and academic practices are still not entirely clear. However, it is believed that the advancement of studies will clarify them.

Reliability and construct validation of the Blended Learning Usability Evaluation–Questionnaire with interprofessional clinicians in Canada : a methodological study

Purpose: To generate Cronbach’s alpha and further mixed methods construct validity evidence for the Blended Learning Usability Evaluation–Questionnaire (BLUE-Q).Methods: Forty interprofessional clinicians completed the BLUE-Q after finishing a 3-month long blended learning professional development program in Ontario, Canada. Reliability was assessed with Cronbach’s α for each of the 3 sections of the BLUE-Q and for all quantitative items together. Construct validity was evaluated through the Grand-Guillaume-Perrenoud et al. framework, which consists of 3 elements: congruence, convergence, and credibility. To compare quantitative and qualitative results, descriptive statistics, including means and standard deviations for each Likert scale item of the BLUE-Q were calculated.Results: Cronbach’s α was 0.95 for the pedagogical usability section, 0.85 for the synchronous modality section, 0.93 for the asynchronous modality section, and 0.96 for all quantitative items together. Mean ratings (with standard deviations) were 4.77 (0.506) for pedagogy, 4.64 (0.654) for synchronous learning, and 4.75 (0.536) for asynchronous learning. Of the 239 qualitative comments received, 178 were identified as substantive, of which 88% were considered congruent and 79% were considered convergent with the high means. Among all congruent responses, 69% were considered confirming statements and 31% were considered clarifying statements, suggesting appropriate credibility. Analysis of the clarifying statements assisted in identifying 5 categories of suggestions for program improvement.Conclusion: The BLUE-Q demonstrates high reliability and appropriate construct validity in the context of a blended learning program with interprofessional clinicians, making it a valuable tool for comprehensive program evaluation, quality improvement, and evaluative research in health professions education.

Evaluation of an oral health education training program for kindergarten teachers

ObjectivesThis study aims to examine kindergarten teachers’ satisfaction and their perceived impact of an oral health education (OHE) training program.MethodsThis study followed the steps outlined in the Program Evaluation Standards in Public Health recommended by the Centers for Disease Control and Prevention. All kindergarten teachers in Hong Kong were invited to attend the OHE training. The training comprised a lecture and a group discussion among six to eight teachers facilitated by trained dentists. The participating teachers were invited to complete an online questionnaire after the training. The questionnaire consisted of seven questions: six close-ended questions to evaluate teachers’ satisfaction with the training, their perceived oral-health-related knowledge, and their perceived competence in delivering OHE, and one open-ended question to collect their comments and suggestions for enhancing the OHE training.ResultsA total of 6,210 teachers joined the OHE training and 4,882 teachers completed the questionnaires (response rate: 79%). The survey found that 4,691 (96%) teachers were satisfied with the training, and the same number agreed that the OHE training was essential for delivering OHE. In addition, 4,680 (96%) teachers found the lecture informative and 4,393 (90%) teachers rated the group discussion as useful. After the OHE training, 4,716 (96%) teachers reported that they were more knowledgeable in recognizing childhood oral diseases and 4,665 (96%) teachers believed they were more skillful in delivering OHE. Regarding comments and suggestions, teachers opined that the OHE was informative and comprehensive. They suggested developing videos and hands-on workshops for the OHE training and expressed a desire to learn more about the dental treatment of common dental diseases. They also recommended providing teaching aids, such as booklets and tooth models, for use in kindergartens.ConclusionThe kindergarten teachers generally had a better understanding of childhood oral conditions after the OHE training. They were generally satisfied with the training and became more confident in delivering OHE to kindergarten children.

Freedom of Curriculum: Evaluation of CIPP Early Childhood Education Co-Curricular Activities Program in Baruga Kendari City

This study aims to evaluate the co-curricular activity program in Early Childhood Education (PAUD) in Kendari City using the CIPP (Context, Input, Process, Product) evaluation approach. Data were collected from 6 schools with 43 respondents consisting of PAUD educators and managers, using an instrument in the form of a questionnaire that was analyzed descriptively quantitatively. The results of the study indicate that in the Context aspect, the condition of the school, students, educators, and school environment are in the good category with an average value of 14.40, 10.72, 10.79, and 10.86, respectively. In the Input aspect, facilities and infrastructure are considered quite adequate (mean 17.74), while the budget and involvement of external parties are still the main challenges with an average value of 11.19 and 10.49, respectively. Educator training is in the fairly good category with an average value of 13.91. In the Process aspect, student participation in co-curricular activities reached a good category (mean 14.12), while the professional and pedagogical competence of teachers showed very good results with an average of 25.02 and 32.33. In the Product aspect, the increase in student competence and the quality of co-curricular activities were in the good category, with average values of 17.91 and 21.12, respectively. This study concludes that the co-curricular activity program at PAUD in Kendari City as a whole has been running well, although improvements are still needed in the budget aspect and external party involvement to optimize results. Strategic recommendations include optimizing financial support, ongoing training for teachers, and closer collaboration with communities and external institutions.

Parental Evaluation of a Responsive Parenting Program for Infants with Hearing Loss.

Parental satisfaction is an important factor in the evaluation of early intervention programs but is rarely investigated. The Muenster Parental Program (MPP) is a short, evidence-based early intervention program that focuses on parental responsiveness. It is a family-centered intervention for parents of infants aged 3-18 months who have recently been diagnosed with hearing loss and fitted with hearing devices, including prior to or following cochlear implant surgery. We aim to receive feedback from parents regarding the process and outcomes of their participation in the MPP. Following their participation, all participants of the MPP were asked to complete an evaluation questionnaire. This article reports feedback from the first 52 participants (44 mothers, 7 fathers, and 1 godmother). Their infants (N = 45) had moderate to complete hearing loss, they were aged 2-20 months, and 40% of them had an additional disease, disorder, and/or developmental delay. Parents reported high levels of satisfaction with the content, didactics, setting, and individual benefits of the intervention, and a high recommendation rate (92%). The aspects most appreciated were meeting other affected parents and the concrete individual support of parent-child communication, including video feedback. Almost all parents (96%) reported a change in their communication style with their child. This confirms the results of a previous controlled intervention study on the enhancement of parental responsiveness via the MPP. This evaluation of the MPP from a parental point of view has revealed equally high satisfaction with the content, setting, and didactics amongst all parents regardless of any potentially influential parent or child variables. The MPP is well suited to a wide range of close caregivers' needs despite the known diversity of children with hearing loss and their parents or families.

Evaluasi Program Pembelajaran Pendidikan Agama Islam Menggunakan Model Context, Input, Process and Product di SDN 430 Pandoso Kabupaten Luwu

This article discusses the evaluation of the Islamic Religious Education learning program at SDN 430 Pandoso, Luwu Regency using the Context, Input, Process and Product (CIPP) evaluation model. The purpose of this study is for researchers to determine and assess the success of the learning program and its suitability for the Islamic learning curriculum at the school. This research discusses program evaluation based on the CIPP model proposed by Stufflebeam. In this study, context, input, process, and product are used as the four elements of evaluation. The study involved 32 fourth and fifth grade students and Islamic religious education teachers. Information for this study was collected through documentation, interviews, observation and questionnaires. Furthermore, qualitative data analysis and quantitative data analysis were used as methods to analyze the data in this study. The results of this study indicate that there are discrepancies between programs and learning plans, human resources, facilities and infrastructure, learning media, learning methods and student learning outcomes. Based on the results of research on the evaluation of the Islamic Religious Education learning program using the CIPP model obtained an average percentage of 81% with a very good category based on the results of the input evaluation of 78% with a good category, process evaluation of 85% with a very good category and product evaluation of 86% with a very good category. As a recommendation, this study suggests concrete solutions such as focused training for teachers, utilization of technology in learning, using active learning methods and providing additional learning to students so as to create effective and quality learning. The evaluation of the learning process also highlighted the need for guidance to teachers in making and operating learning media.

Experience with a Self-Management Education Program for Adolescents with Type 1 Diabetes: A Qualitative Study.

Background/Objectives: Adolescents with type 1 diabetes face complex challenges associated with the disease, underscoring the importance of developing self-management skills. This study examined participants' perspectives on a type 1 diabetes self-management education program. Methods: Focus group interviews were conducted with 32 adolescents with type 1 diabetes who participated in the program and six expert patients. Both thematic analysis and content analysis were conducted using NVIVO software, version 1.6.1. Results: Two dimensions emerged: expert patient roles and program evaluation. Expert patient roles were viewed positively, with an emphasis on responsibility, sharing experiences, and being a role model. Program evaluation emphasized peer-to-peer sharing and educational sessions, with increased knowledge of the disease and management strategies. Expert patients also benefited from the program by developing a sense of responsibility, serving as role models for adolescents, and improving their disease self-management. Conclusions: The adolescents emphasized that the program was a learning tool and the expert patient's view of their role emerges, highlighting modelling as a facilitator of learning and of the responsibility and commitment of the mentors. This study reinforces the benefits of peer-to-peer interaction in a camp setting, including rich experiences.

An evaluation of a community dementia screening program in rural Kenya: DEM-SKY.

This study describes the implementation outcomes and evaluation of DEM-SKY, a community-based dementia screening program developed in rural Kenya with the support of community health care workers (CHWs). DEM-SKY was delivered to 3546 older adults in Makueni County, Kenya, over a 6-month period. Using a mixed-methods design, we explored implementation outcomes with stakeholders through surveys and interviews. The program demonstrated good acceptability, adoption, and fidelity and was effective in instigating behavior change. Individuals who screened positive for dementia were 28.7 times more likely to intend to speak to a doctor. Qualitative data showed that participants valued the program but indicated scope for improvement, particularly further down the diagnostic pathway. DEM-SKY was successful across several implementation metrics. Although the program demonstrates that community-based screening can be conducted effectively with minimal resources, future research needs to explore the long-term benefits of dementia screening in Kenya. Community-based dementia screening is feasible in rural Africa. Involving community health workers strengthens trust in health care systems. Empowering community health workers enhances the community capacity to address dementia Screening promotes proactive health seeking among older adults.

Analysis of the Hamstring Injuries among Soccer Athletes

Nowadays, as the injury rate of hamstring injuries increases, it is important to find the effective recovery method. This article is in order to explain the reasons of why soccer athletes get hamstring injuries based on the detailed analysis of the injured structure anatomy of people, and discuss the functions and mechanisms of the injury, which include stretch and sprinting. Then explain both the modifiable and non-modifiable risk factors and risk group of human such as older people who has muscle weakness and the athletes who already experience the same injuries. Finally, the article provides several rehabilitation methods which can help athletes to do the recovery step by step, from soft tissue injuries, to reducing the inflammation and pain, then doing physiotherapy which includes the muscle strength training and flexibility training. Besides, it also gives an evaluation of each rehabilitation program to find the most effective and useful one and it also compare the similar rehabilitation program of L-protocol groups and C-protocol groups in many aspects. The common results show that by doing effective recovery, can help athletes with hamstring injuries return to the sports quickly. After that, several prevention methods are given in the article, such as doing warm up program and stretching before doing the sports, which can help athletes avoiding getting those kinds of injury

MATES in Manufacturing: A Cluster RCT Evaluation of a Workplace Suicide Prevention Program.

The MATES in Construction suicide prevention program was adapted to the manufacturing sector and evaluated in a pilot of the program. Ten manufacturing worksites were randomly assigned to intervention (5 sites) and wait-list control (5 sites) conditions in a two-arm cluster randomized design. 1245 workers responded at baseline (87% response rate) and 648 at final (35% response rate). Literacy of Suicide Scale (LOSS) was assessed as a process outcome, and help-seeking intentions as the primary outcome (General Help-Seeking Questionnaire [GHSQ] score). Secondary outcomes included help sought, suicidal thoughts and likelihood of suicide attempt scores, and Kessler-6 scores. Linear mixed models for repeated measures were used in intention-to-treat (ITT) and completer analyses. All sites finished the trial, with intervention periods ranging from 8 to 11 months; however, none of the five intervention sites fully implemented the intervention as planned. ITT analyses showed an improvement in LOSS scores within the intervention group (0.49, 95% CI 0.13-0.49), but the mean difference in change between intervention and control included the null (0.34, 95% CI -0.10 to 0.80). The primary outcome of GHSQ scores also improved within the intervention group, but the difference in change included the null (mean difference 1.52, 95% CI -0.69 to 3.74). No secondary outcomes improved relative to control in ITT or completers analyses. Exploratory analysis of disaggregated GHSQ help sources showed greater improvement in mean difference in change for the main MATES message of seeking help from MATES Connectors. The intervention, as implemented, was not effective at achieving the primary or secondary outcomes. Australian and New Zealand Clinical Trial Registry: ACTRN 12622000122752.

An Integrated Two-Step Optimization Model and Aggregative Multi-Criteria Approach for Establishing Sustainable Tram Transportation Plan

The choice of the most appropriate sustainable scheme for the organization of tram transportation in cities is of great importance for tram operators, for users of transportation services, and for the protection of the environment from harmful emissions. This study aims to propose a methodology for formulating a tram transportation plan considering technological, environmental, economic, and social indicators. The variant schemes represent the routes of a tram in the tram network. The methodology includes four stages. The first stage involves the determination of variant schemes for a transportation plan of service with trams. In the second stage, a two-step optimization model is proposed to determine the number and trams by types for each tram route for each variant scheme, and also to establish the distribution of trams by depots. The third stage includes ranking the variant schemes by applying the sequential interactive model for urban systems (SIMUS) multi-criteria method. Eleven quantitative and qualitative criteria for evaluating the tram transportation plan were introduced. A verification of the results is performed in the fourth stage. For this purpose, a comparison of the preference ranking organization method for enrichment of evaluations (PROMETHEE) method and the technique for order of preference by similarity to ideal solution (TOPSIS) method is made. Both methods have different approaches for decision making and differ from the SIMUS method. Two strategies were proposed to determine the criteria weights. One is based on the Shannon entropy method and the other uses the objective weights obtained through the SIMUS method. Finally, in the fifth stage, the results obtained through the SIMUS, PROMEHEE and TOPSIS methods are combined using the expected value obtained by applying the program evaluation and review technique method (PERT). The proposed methodology was applied to study tram transportation in Sofia, Bulgaria. Five variant schemes were considered. The schemes are optimized through the criterion of minimum energy consumption. The number of trams by routes and by type was determined. An improved scheme for tram transportation in Sofia was proposed. The scheme makes it possible to increase the frequency of the trams by 13%, to reduce the zero mileage of rolling stock, and to reduce carbon dioxide pollution by 11%.

Evaluation of an interprofessional education program involving medical and pharmacy students: a mixed-method study

BackgroundEffective pharmacotherapy requires strong collaboration between physicians and pharmacists, highlighting the need for interprofessional education (IPE) in university curricula. This study evaluated the impact of an IPE program on medical and pharmacy students, focusing on their perceived development of interprofessional collaborative competencies, perceived learning outcomes, and clinical collaboration perceptions.MethodsA mixed-method approach was employed to evaluate an IPE program that consisted of three mandatory activities with increased complexity and autonomy, that were integrated into the medical and pharmacy students’ curricula. From September 2022 to June 2023, using a retrospective pre-post approach, students rated their competence levels after an educational activity using the Interprofessional Collaborative Competency Attainment Scale (ICCAS). The participants also answered open-ended survey questions about their learning outcomes. Medical students participated in both uniprofessional education (UPE) and IPE, while pharmacy students participated exclusively in IPE. Effect sizes for competency development were estimated, and subgroup analyses were performed to examine the impact of multiple IPE activities. Semi-structured interviews provided additional qualitative insights, which were analyzed using thematic analysis.ResultsOf the 309 surveys completed (response rate 64%, with 274 medical and 35 pharmacy students), all 21 ICCAS items showed statistically significant improvement in both UPE (n = 127) and IPE (n = 182) (p < 0.05). While effect sizes for UPE were small across all items, IPE had medium effect sizes for six items and large effect sizes for two items. Overall, students rated themselves as more capable of interprofessional collaboration after IPE, with 55% (n = 124) reporting feeling 'somewhat better' and 6% (n = 14) feeling 'much better,' compared to 16% (n = 12) and 0%, respectively, after UPE. Competency development seems to improve slightly with an increased number of IPE activities. Pharmacy students reported somewhat higher post-activity scores than medical students did. Qualitative data from open-ended survey responses and interviews with six medical students and four pharmacy students highlighted a deeper understanding of professional roles and a greater appreciation for collaborative work through this program.ConclusionsThis IPE program focused on pharmacotherapy improved self-perceived interprofessional collaborative competencies among medical and pharmacy students. Through multiple interprofessional activities, students can develop a deeper understanding of professional roles and improve collaborative skills.