Expertise In Management Research Articles

Retrospective Observational Analysis of Computed Tomography Scans of Trauma Patients in Overseas Operations (SCANOPEX Study).

High-intensity conflicts are on Europe's doorstep. The French expertise in the medical management of frontline casualties in overseas operations is well established. However, in the management of severe trauma, we lack data on the injuries identified by body scanners in the field. Understanding the associations between injury mechanisms and radiological lesions would enable us to anticipate medical and surgical management. To study this possible link, we collected and interpreted scanogaphic data and analyzed them according to lesion mechanisms, following the algorithm MARCH used to implement the concept of Damage Control Resuscitation, which includes life-saving measures to ensure that the wounded reach medical-surgical facilities alive. This retrospective monocentric study collected data from body scanners performed in overseas operations between June 2011 and September 2023. Inclusion criteria were to be French military personnel and to have undergone a whole-body scanner in a theater of overseas operations. Exclusion criteria were to have died before the scan, to be foreign, non-military and a minor. Of 164 available files, 96 were eligible, 1 patient declared aged 70 years was excluded, and 95 files were retained. In our population, 18% of injured patients had a spinal fracture. Compared with road traffic accident casualties, improvised explosive device casualties were the most severely injured patients arriving alive at computed tomography, with a relative risk of Injury Severity Score > 8 of 2.29 [1.09-4.80] (P = .019). Improvised explosive device casualties had a relative risk of airway injuries of 2.57 [1.03-6.39] (P = .030), injuries leading to functional impairment of 3.21 [1.17-8.82] (P =.013), injuries leading to infection of 2.14 [1.21-3.76] (P = .0045), and injuries leading to shock of 3.21 [0.96-10.70] (P = .039). Deep metal splinters were only found in the improvised explosive device group. Preparing the medical corps to deal with war casualties is fundamental. Our study shows that it is essential to consider the mechanism of injury to understand the casualty better and predict potential injuries. In addition, the study of postmortem scans could greatly help analyze potentially avoidable deaths.

Shared Accountability Shaping the Destinies of Individual and Groups of Nonhuman Primates

At the California National Primate Research Center (CNPRC), the preferred housing for rhesus macaques involves maintaining them in complex social groups outdoors, primarily for breeding purposes. This functionally appropriate environment promotes effective coping through the expression of species-typical behaviors and important aspects of species-typical social structure, thus enabling normal animal development, higher reproductive success, and the production of high-quality biological models. Despite the benefits, social housing introduces challenges like trauma from aggressive interactions. These challenges necessitate a delicate balance between tolerating some aggression and preventing repeated targeting of individuals. Therefore, the CNPRC has established a multidisciplinary working group of behavioral management experts, veterinarians, animal care, and researchers that meets regularly to review cases of animals that may need to be removed from their social group. We discuss the criteria and decision-making processes employed to manage and mitigate aggression. We describe the systematic approach to identifying at-risk individuals and the comprehensive evaluation process that guides whether to relocate an animal from their groups or not. Considerations include the welfare of the individual and the group’s social stability. This paper provides case studies demonstrating how the working group applies these criteria and processes in practical scenarios, highlighting the complexities and challenges of such decisions.

Areas of uncertainty on the diagnosis, treatment, and follow-up of hypophosphatemia in adults: an Italian Delphi consensus.

The study aimed to present the results of a Delphi consensus involving Italian experts focusing on the management of hypophosphatemia in adults. A multidisciplinary advisory board of nine physicians, experts in hypophosphatemia management, was established. Next, a literature search was performed to identify international guidelines, consensus, and clinical pathways, which were later presented to the advisory board. Collaboratively, the advisory board and authoring team selected key statements for the consensus process and focused on areas of uncertainty related to the management of hypophosphatemia. The advisory board also indicated the experts to be invited to participate in the consensus process. The Delphi method was employed to reach a consensus. The literature search yielded one guideline, five consensus documents, and one clinical pathway. While our search strategy aimed to identify documents on the management of all types of hypophosphatemia, most of the guidelines and consensus documents retrieved focused on X-linked hypophosphatemia. The consensus process focused on 11 key issues, achieving strong convergence (over 70% consensus) in the first Delphi round for 8 out of the 11 statements. Three statements proceeded to the second round, with strong agreement reached for two. Notably, consensus was not reached for the statement concerning the measurement of fibroblast growth factor 23 for diagnostic purposes. The study revealed that the community of clinical experts is well-informed and in agreement regarding hypophosphatemia management. It emphasized the importance of developing clear national guidance documents to support clinicians and multidisciplinary teams in patient management. These documents are crucial not only for healthcare professionals but also for those responsible for defining pathways and services, facilitating a more accurate management of hypophosphatemic patients.

Assessing Information Technology in Hospitals in Tehran: Challenges and Opportunities for Performance Improvement

Purpose: This research aimed to investigate the maturity level of information technology (IT) within hospitals in Tehran. Method: The study was applied in purpose and survey-based in method. The statistical population comprised 27 experts in urban management and IT within hospitals in Tehran. A revised standard questionnaire, based on Gartner’s IT management process maturity model, was used to measure IT maturity. Data analysis was performed using SPSS software (version 23). Findings: The study revealed that several aspects of IT maturity within hospitals in Tehran were generally favorable. Specifically, leadership and IT management activities, customer-oriented service, control and evaluation, configuration and asset management, security management, change management, service level management, accessible management, service and support documentation, capacity management, and strategic trends were positively evaluated. However, operations management, human resource management, supplier management, and certain IT service management components were found to be below the average level of 3. Conclusion: Overall, the research indicates that the IT maturity level in hospitals in Tehran is largely favorable. Nevertheless, improvements are needed in specific areas, such as operations management and human resource management, to enhance the effectiveness and efficiency of IT operations.

Children's Heartbeat: A Web-Based Program to Spread Knowledge on Arrhythmias in Children.

Expertise in pediatric arrhythmia management is lacking in most low- and middle- income countries (LMIC). Strategies to disseminate education in pediatric electrophysiology are essential to meet this need. Children's Heartbeat was created to meet the growing demand for pediatric electrophysiologic consultation in LMIC. Children's Heartbeat is a virtual video-conferencing program that uses the Extension for Community Healthcare Outcomes model to disseminate knowledge about pediatric arrhythmia management from pediatric electrophysiologists to clinicians in medically under-resourced regions worldwide. Monthly virtual case-based sessions are held with pediatric electrophysiologists and clinicians in medically under-resourced settings to discuss pediatric electrophysiology management. Since its inception, Children's Heartbeat viewership has grown exponentially to include 181 total registrants, 64 average monthly participants, and an additional 121 average viewers of recorded sessions. Attendees have expressed increased confidence in pediatric arrhythmia management. Children's Heartbeat has successfully provided pediatric electrophysiology consultation to medically under-resourced regions globally and have increased clinicians' confidence in caring for children with arrhythmias. Future directions include spreading the program to general pediatric and pediatric cardiology trainees and practicing pediatricians in rural parts of high-income countries and evaluating the direct impact of Children's Heartbeat on the management of arrhythmias in pediatric patients in LMIC.

Pengembangan Model Sistem Penjaminan Mutu Internal di Pondok Pesantren

The community has the right and responsibility for the existence of quality educational institutions. similar to the regulations contained in Law Number 18 of 2019 concerning Islamic boarding schools that the implementation of an internal quality assurance system absolutely must be carried out well. However, based on the results of research conducted in several Islamic boarding schools in Bogor, we do not fully understand the stages of quality assurance. Several existing Islamic boarding schools have a quality assurance team but they are not the oldest in the organizational structure. This means that the human resources appointed as the quality assurance team include but are not legally formalized in a decision letter, this means that the Islamic boarding school implements quality assurance components but is not implemented administratively. This research aims to first, analyze the need for developing an internal quality assurance system model in Islamic boarding schools. Second, to develop an internal quality assurance system model in Islamic boarding schools. Third, to test the feasibility of the internal quality assurance system model in Islamic boarding schools. The research uses the Research and Development method, using the ADDIE model. The results of the research findings showed that the analysis of the need for developing an internal quality assurance system in Islamic boarding schools was carried out in the first two stages of the field needs analysis consisting of 9 Islamic boarding schools with 11 respondents. The conclusion was that 100% of respondents needed an internal quality assurance system model for Islamic boarding schools to guarantee the quality of education. boarding school. Second, document analysis consisting of internal quality assurance system documents issued by the Ministry of Education and Culture's primary and secondary education, as well as internal quality assurance system regulations issued by law number 18 of 2019 concerning Islamic boarding schools, became a reference in preparing a model for the internal quality assurance system in Islamic boarding schools. . The Islamic boarding school internal quality assurance system model produces a product in the form of the SPMI model in Islamic boarding schools which explains the internal quality assurance cycle including planning the quality of Islamic boarding school education, preparing plans to improve the quality of Islamic boarding schools, implementing plans to improve the quality of Islamic boarding schools, monitoring and evaluating the implementation of plans to improve the quality of Islamic boarding schools, setting standards. new quality and developing strategies to improve the quality of Islamic boarding schools. Third, a one to one test was carried out with educational management experts, linguists and experts in the field of Islamic boarding school with validation test results by experts in educational management of 81% "decent", language experts of 88% "very worthy", experts in the field of Islamic boarding school of 76%. "worthy". Then revisions were made based on the experts' assessments and suggestions to produce a second prototype. The next stage is implementation in the form of implementation, carrying out a feasibility test on practitioners with an average validation result of practitioners of 90% "very feasible", then producing a third prototype. Next, it goes to the final stage, namely evaluating the third prototype by carrying out revisions based on previous expert assessments so that a product is produced. end. As for the evaluation stage, which is the final stage, you get the assessment results with an assessment result in the range of 80-100 "very good"..

Resuscitation strategies for surgical patients in the neonatal intensive care unit

Resuscitation of an infant with surgical complications includes both perioperative and post-operative management. In most cases this requires a multidisciplinary approach to achieve the best outcomes. Challenges include immediate expert management at infant delivery with the use of protocolized care, available anesthesia expertise, close monitoring of electrolytes with prompt attention to fluid status, and meticulous pain management. In this review, we will address contemporary research and ongoing challenges associated with resuscitation. We will make recommendations for effective resuscitation of this vulnerable and unique population from premature infant to term infant with complex surgical needs.

Expert perspectives on disaster risk reduction strategies in the tourist area of Borobudur-Yogyakarta-Prambanan in Indonesia

Tourism plays a crucial role in the economic growth of many countries. However, tourist destinations located in disaster-prone areas face increased vulnerability in the event of natural disasters. It is essential for these areas to have specific interventions, plans, and policies that focus on reducing disaster risk, while ensuring the safety of residents and tourists. This study proposes strategies for minimizing disaster risk using Indonesia's Borobudur-Yogyakarta-Prambanan (BYP) region as a case study. The study used an Analytical Hierarchial Process in a Strengths Weaknesses Opportunities and Threats (SWOT-AHP) analysis to prioritize factors through pairwise comparisons and develop strategic alternatives based on expert perspectives. Primary data were collected through aSWOT-AHP questionnaire that was provided to 22 experts in tourism and disaster management in Central Java and Yogyakarta Special Provinces. Secondary data were obtained from government documents, specifically the Disaster Risk Reduction Plan for the BYP regions (2023–2027). The results indicate that “implementing land-use policies to promote tourism development while considering disasters” is the most important strategy, based on expert judgment. The BYP tourist destinations provided a case study to identify strategies to reduce disaster risk in tourism areas.

Development of an educational program in pelvic floor health for women: A consensus using the Delphi method

ObjectivePelvic floor health education workshops for women appear to improve women's knowledge and pelvic floor symptoms. Our aim was to obtain expert consensus on the content and format of a pelvic floor health education program using the Delphi method. Material and methodsA two-round Delphi study was conducted involving French-speaking multidisciplinary experts in pelvic floor dysfunction management. The first round questionnaire contained 44 items (31 about the program's content and 13 about the materials). They were also consulted about the optimal format of the program (duration and number of workshops) as open questions. Participants rated their level of agreement with each item on a Likert scale from 1–9. Consensus was defined by a level of agreement≥80% and a median≥7. Non-consensus items were reworked and resubmitted to the experts for the second round. ResultsOf the 110 experts contacted, 52 responded for the first and second rounds. Sixty-one percent of the proposed items met with consensus in the first round and 60% in the second. The final program comprises 33 items: eight on anatomy, four on biomechanics, nine on urinary and defecatory physiology, seven on risk factors, and five on materials. The format selected by the experts consisted of four or five 75-minute health education sessions with a paper summary hand out at the end of the program. ConclusionsThis study defined the content of a pelvic floor health education program for the general population of adult women validated by a consensus of experts. After validation of an English version, it should be evaluated in international interventional studies.

Organizational culture and leadership style in Spanish Hospitals: Effects on knowledge management and efficiency

Hospital culture and leadership style have attracted considerable attention in research, with compelling evidence indicating their potential competitive advantages, including their crucial role in ensuring the successful implementation of knowledge management and its impact on hospital efficiency. The aim of this paper is to identify the effects of organizational culture and leadership style on knowledge management and hospital efficiency. Fuzzy cognitive maps (FCMs) are relational models that can be used to represent the opinions and knowledge of expert to infer cause-effect relationships among different concepts. The use of FCMs as a simulation tool enables the evaluation of potential scenarios based on different organizational cultures and leadership styles in hospitals. Developing an FCM for this study involved several steps. Firstly, data were collected through interviews with 21 experts in hospital management. The interviews were conducted between May and September 2023 either face-to-face or via videoconference. Once individual cognitive maps had been created, consensus among them was achieved through a multicriteria decision-making process, wherein the expert opinions were averaged. The separate cognitive maps of each expert were then integrated to produce a single FCM using the augmented FCM approach. Reflecting expert insights from the FCM, hospitals with a hierarchy culture exhibit diminished levels of knowledge creation, management, and overall hospital efficiency, whereas those with an adhocracy culture show improvements in knowledge creation, knowledge exploitation, and overall hospital efficiency in comparison to alternative ones. From the experts' FCM perspective regarding leadership style, transformational leadership achieves the highest level of knowledge management and hospital efficiency in hospitals with an adhocracy culture. Finally, this paper offers a reference for practising knowledge management and improving hospital efficiency through adhocracy culture and transformational leadership.

Le cancer thyroïdien différencié réfractaire à l’iode : quelle prise en charge en 2024 ?

TREATING RADIO-IODINE REFRACTORY DIFFERENTIATED THYROID CANCER IN 2024: About 5 to 10% of patients with differentiated thyroid cancer (DTC) have advanced tumors at presentation or recurrence, with invasive cervical disease and/or distant metastases that cannot be effectively treated by conventional treatment, i.e. thyroid surgery and radioactive iodine. These DTC cases are defined as refractory to radioiodine (RAIR) and require expert multidisciplinary management. In France, patients are referred to centers of the ENDOCAN-TUTHYREF Network. This review summarizes current management of RAIR DTC patients and therapeutic options available in 2024. We discuss following topics : epidemiological data, modalities of local ablative treatment for selected metastatic lesions, molecular tests to be performed, optimum timing for initiating systemic therapy, choice of first-line treatment among validated tyrosine kinase inhibitors (TKIs), alternative targeted treatments (including selective TKIs adapted to the molecular profile, some of which can redifferentiate and restore radioactive iodine uptake), proactive management of TKI side effects, and finally give an overview of systemic strategies. Management of RAIR DTC is still challenging but substantial progress has been made over the last decade that has significantly improved outcome for these more aggressive thyroid cancer.

A research data management (RDM) community for ELIXIR.

Research data management (RDM) is central to the implementation of the FAIR (Findable Accessible, Interoperable, Reusable) and Open Science principles. Recognising the importance of RDM, ELIXIR Platforms and Nodes have invested in RDM and launched various projects and initiatives to ensure good data management practices for scientific excellence. These projects have resulted in a rich set of tools and resources highly valuable for FAIR data management. However, these resources remain scattered across projects and ELIXIR structures, making their dissemination and application challenging. Therefore, it becomes imminent to coordinate these efforts for sustainable and harmonised RDM practices with dedicated forums for RDM professionals to exchange knowledge and share resources. The proposed ELIXIR RDM Community will bring together RDM experts to develop ELIXIR's vision and coordinate its activities, taking advantage of the available assets. It aims to coordinate RDM best practices and illustrate how to use the existing ELIXIR RDM services. The Community will be built around three integral pillars, namely, a network of RDM professionals, RDM knowledge management and RDM training expertise and resources. It will also engage with external stakeholders to leverage benefits and provide a forum to RDM professionals for regular knowledge exchange, capacity building and development of harmonised RDM practices, keeping in line with the overall scope of the RDM Community. In the short term, the Community aims to build upon the existing resources and ensure that the content of these remain up to date and fit for purpose. In the long run, the Community will aim to strengthen the skills and knowledge of its RDM professionals to support the emerging needs of the scientific community. The Community will also devise an effective strategy to engage with other ELIXIR structures and international stakeholders to influence and align with developments and solutions in the RDM field.

Can the Phenomenon of Automobile Electrification be transformed into the Development Direction of the Automobile Industry?

Internationale Automobil-Ausstellung Show in 2023 just came to an end. In April, 2024, German Federal Chancellor Scholz led a huge business delegation to visit China (China Digital Space, 2024) Germany, which has always been proud of the automobile industry and technology, has caused a heated discussion about the development direction of the automobile industry from professional automobile media to online self-media[2]. As an international student studying advanced business management expertise in Germany, the author is curious about this changes. In particular, the latest media reports show that Apple has given up pushing forward the car-building project for nearly 10 years. Subsequently, Källenius, Chairman and CEO of Mercedes-Benz Group, also said that Mercedes-Benz would no longer adhere to the original goal of fully turning to electric vehicle sales in major markets by 2030. Previously, Mercedes-Benz's pursuit of motorization was fanatical. In 2021, Mercedes-Benz proposed an all-electric strategy. The goal is that the sales of all-electric and plug-in hybrid vehicles will reach 50% by 2025. Starting from 2030, Mercedes-Benz will be basically transform into an all-electric vehicle. These developments once again aroused the author's interest in whether motorization will become the development direction of the automobile industry. Hegel, a German philosopher, once pointed out in Science of Logic that existence is a phenomenon but it is not an illusion. Illusion corresponds more to existence, and phenomenon is higher than existence with richer connotation, because phenomenon contains its own reflection and reflection of other things, and phenomenon itself also has its own internal stability contradiction. Germany is a country of rational speculation, and the appearance of any phenomenon will not affect the Germans' thinking and exploration of its essence. Similarly, from the perspective of subjective feeling and rational analysis, this paper will try to discuss the change of German automobile consumption trends from the perspective of commercial marketing, and then prove the inherent logic of some industry behind the trend. With interest in learning and thinking, the author tried to drive a fuel-powered car and an electric car by himself. One is a German Mercedes-Benz GLC 300 manufactured and sold in China. This car is very popular among middle class consumers in China. Another model that I test drive is the M9, which was launched in the fourth quarter of 2023. It was jointly developed by Huawei, a network intelligent terminals supplier in China, Energy storage battery maker called Ningde Times and Seres Veicles. According to the report of China's mainstream media, China National Radio Network, on March 19,2024, the media once again held the top five positions of luxury brands with a weekly sales volume of 86,000 vehicles, and tried out two models. Another market factor is that the sales price of these two models are in the range of 500 thousand to 600 thousand RMB.

Identification and Management of Post-Stroke Spasticity

Abstract Background Spasticity is thought to affect up to 40% of people with severe weakness after stroke, with 15% of those experiencing severe and disabling spasticity. Untreated, it can lead to pain, increased dependence, contracture and other motor impairments (National clinical guideline for stroke for the UK and Ireland, 2023). Guidelines recommend that people with motor weakness should be assessed for spasticity, and spasticity guidelines recommend that all people with problematic spasticity should be managed within a specialist service, using physical and pharmacological management as appropriate (Royal College of Physicians, 2018). The objective of this study was to determine the prevalence of spasticity reported by patients attending a post stroke review clinic, and the subsequent management of these patients. Methods Participants: All patients attending a post-stroke review clinic between March 2023 and April 2024. Data: All patients were asked if they experience stiffness, cramping or spasms. Responses and subsequent onward referrals were recorded. Where patients were referred onward for further assessment and management, the interventions employed were recorded. Analysis was performed using descriptive statistics. Results During the data collection period, 270 patients visited the clinic. Stiffness, cramps or spasms were reported by 32 (11.9%), with the majority of these (n=27, 84%) referred to a specialist physiotherapist with expertise in spasticity management for comprehensive assessment. Of the referred patients, 5 (18.5%) did not attend their appointments, 5 (18.5%) are still awaiting appointments, 6 (22.2%) were diagnosed with non-neural stiffness, and 9 (33.3%) received botulinum toxin injections at a specialist physiotherapist-led spasticity clinic. Conclusion Data from this exploratory study indicates the importance of assessing spasticity in patients post stroke and highlights the importance of access to a physiotherapist with specialist knowledge and skills in spasticity management.

The pivotal role of head and neck surgeons in advancing thyroid ablation practices

Thyroid ablation techniques are becoming increasingly popular across various specialties, leading to significant advancements in the treatment of thyroid and head and neck diseases. Head and neck surgeons (HNS) play a pivotal role in advancing thyroid ablation practices due to several key advantages: their detailed understanding of the thyroid and head and neck anatomy, extensive experience with ultrasound and ultrasound-guided interventions, ability to manage post-ablation conditions, capability to perform surgeries if necessary, and expertise in voice assessment, rehabilitation, and management. In this narrative review, we combine a comprehensive literature review with our own decade-long experience in promoting thyroid ablation to demonstrate that HNS are essential in advancing these techniques, ensuring safety, and improving patient quality of life.

2024 UK and Ireland modified Delphi consensus on myopia management in children and young people.

This work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP). A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management. Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non-commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first-line treatments. The role and provision of low-concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low-concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non-cycloplegic axial length 6 monthly. Research is needed to identify those at risk of progression, the long-term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant.

Contribution to the Iberian thermomediterranean oak woods (Spain, Portugal): the importance of their teaching for the training of experts in environmental management

The study of the holm oak forests of the lower and upper mesomediterranean of the south of the Iberian Peninsula, and new syntaxons of holm oak forests not assigned until now are contributed. The plant dynamics is provided and completed, and the importance of the learning of plant description and dynamics by university students, future environmental managers, is specified. Taking into account the strong anthropic action with the consequent destruction of holm oak forests, it is necessary to enhance the knowledge of plant dynamics to decipher the potential vegetation, and to be able to apply the vegetation series as a basis for agronomic and forestry management. In this work, we propose a new vegetation series. We propose the association Aristolochio baeticae-Quercetum rotundifoliae nova for the biogeographic sector Granadino-Almijarense (Montes de Málaga) and as a first dynamic stage of the microforest of Olea europea var. sylvestris obtained by deforestation. The study of the Iberian olive groves allows us to propose two new associations Aristolochio baeticae-Oleetum sylvestris and Ephedro fragilis-Oleetum sylvestris.

The WHO guidelines: the new and the old.

The original World Health Organisation (WHO) cancer pain guidelines were published in 1986 and used globally. Updated guidance was released in 2018. This review compares the 'old' with the 'new' with a closer look at the relevance of the WHO analgesic ladder in the current climate. The new guidelines provide a more evidence based, rigorously developed document including recommendations relating to radiotherapeutic management. There is a more detailed focus on safe opioid prescribing, opioid stewardship and the importance of integrating pain management expertise early on in the cancer journey. There remains a lack of evidence for certain therapies despite their widespread use particularly in relation to adjuvants. The pitfalls of the original renowned analgesic ladder are highlighted including a recognition that omitting 'step 2' is safe, feasible and cost effective. The new guidelines offer more detailed recommendations relevant to clinical practice with a strong focus on safety of opioid prescribing making it relevant in the current climate. The original WHO analgesic ladder is no longer recommended as a strict protocol for cancer pain management.

Development of an educational model with a management approach to improve the competency of diabetes educator nurses; utilizing King's conceptual framework and goal attainment theory

Background Education for diabetes patients is not managed well by diabetes nurse educators because the competency of diabetes nurse educators is low, and the number of diabetes nurse educators in hospitals is not commensurate with the number of diabetes patients, which is much larger. Methods This qualitative phenomenological research uses an exploratory design. Twenty nurse managers and forty staff nurses who participated in the focus group discussion (FGD) were selected using purposive sampling. Nine staff nurses who participated in in-depth interviews were selected using the snowball method. The results of the FGD exploration and in-depth interviews produced components for developing an educational model with a management approach. The development of this educational model uses an input, process, output, and outcome approach. The input uses King’s conceptual framework approach, the method uses the theory of goal attainment and management functions, the output is the competency of nurses to educate diabetes patients, and the outcome is the health literacy of diabetes patients. This educational model was reviewed by three experts: a nursing management expert, a diabetes mellitus expert, and a health literacy expert. Results The educational model for Diabetes nurse educators with a management approach consists of five stages: 1) Educational planning includes identifying educational targets, strategy formulation, and situation analysis. 2) Organizing nursing resources includes strengthening the role of nurses as diabetes educators. 3) Nursing staff includes intraprofessional collaboration and collaboration between nurses and patient families. 4) Direction includes nurses’ motivation for diabetes patients and respecting the culture and values of diabetes patients. 5) Control includes evaluating nurse education for diabetes patients. Conclusion This education model has five competencies, which are structured and systematic so that diabetes nurse educators have the competence to manage diabetes patient education: the personal system, interpersonal system, and social system influence nurse competency.

Trust, Justice, and Expertise in Nuclear Waste Management: A Q-Method Analysis of Environmental Discourses in the United Kingdom

ABSTRACT Nuclear waste is ethically contentious, concerning institutional trust, community engagement and the role nuclear plays in different sociotechnical configurations of energy futures. Using Q-methodology with a diverse UK-based stakeholder group, we find three emergent discourses: a) ‘Managing a distrustful public’, b) ‘Fair and democratic nuclear waste decision-making’, and c) ‘Putting the experts in control’. Although multi-stakeholder support is expressed for geological disposal of wastes, disagreements arise toward the ethics of nuclear-powered energy futures and for community decision-making roles. We recommend that policy authorities must first strengthen community withdrawal rights, and second, renew deliberative democratic decision-making mechanisms within energy policy strategy.