Data Collection Form Research Articles

The tools of tax control: a conceptual perspective

This study focuses on exploring the areas of insufficient knowledge about tax control tools in public and private sector companies, in order to provide a more solid conceptual understanding of this topic. Qualitative and quantitative research was used, employing documentary review techniques and analysis of results, with workers from the Human Resources and Administration areas as a sample. A digital survey and data collection forms were used as research instruments. In summary, the results revealed a diversity of levels of familiarity and comfort with the use of accounting software, tax preparation and online tools provided by the tax agency.

A Major Gap Between the Knowledge and Practice of Mothers Towards Early Initiation and Exclusive Breastfeeding in Afghanistan in 2021.

Initiation of breastfeeding right after birth and exclusive breastfeeding for the first 6 months of life is highly recommended. In this survey, we assessed the knowledge and practice of ever-married women towards early initiation of breastfeeding and exclusive breastfeeding in the Nuristan province of Afghanistan. In a cross-sectional household survey, we enrolled 640 ever-married 15-49years women having a child aged 0-23months in the Parun district of Nuristan province from September to October 2021. Using a standardized data collection form and face-to-face interview, we measured self-reported demographic characteristics and the study outcomes (awareness and practice towards the initiation of breastfeeding within an hour of birth and exclusive breastfeeding for the first 6 months of life). We analyzed the data using survey methods and used bivariate and multiple Poisson regression to assess the covariates of the study outcomes. About 46.9% of ever-married women were 25-34years old, 67.5% never attended school, 30.4% were unemployed, and 86.4% had < $60 monthly income. Overall, 56.8% (95% CI 52.9-60.6) of the women had correct knowledge of the early initiation of breastfeeding, and 51.4% (95% CI 47.5-55.3) initiated breastfeeding early for their last baby. Also, 85.9% (95% CI 82.9-88.4) of the women had correct knowledge of exclusive breastfeeding, but only 32.6% (95% CI 29.1-36.4) exclusively breastfed their last baby for 6months after birth. After adjustment for covariates, women who were 45-49years old (Adjusted Prevalence Ratio [APR] = 1.26), Divorced/Separated (APR 1.68), ever attended school (APR 1.39), monthly income > $115 (APR 1.50) were more likely to start early breastfeeding. Moreover, women who were Divorced/Separated (APR 3.53) were more likely to exclusively breastfeed their babies for 6months after birth. Only over half of the women were aware of and initiated early breastfeeding. Although most women knew about exclusive breastfeeding, less than one-third exclusively breast their babies for 6months after birth. We found several contributing factors, such as age, marital status, education, and income that should be considered for targeted interventions.

An Analysis of Reunifications Between Adopted Adults and Their Birth Relatives

ABSTRACT The life-long nature of adoption and recognition of the often-fragile nature of post-reunion relationships, means adoption agencies have a duty of care and moral onus to facilitate comprehensive support services that can be readily accessed. The Health and Social Care (HSC) Trust Post-Adoption Service was established in 1989, in response to the legislative changes brought about by The Adoption (Northern Ireland) Order 1987. This study employed retrospective file analysis and a purposive sample of 15 Case Files, drawn from a 10-year period (2009–2018), to explore reunifications between adopted adults and their birth relatives, from the time of initial involvement and over the longer term. The use of an Advisory Panel of professional experts, a Pilot Study and a specifically created Data Collection Form, enhanced overall rigour and robustness. Thematic analysis of the data identified common themes of curiosity; identity related; meeting the birth mother; and death of adoptive parents/loss; leading to meta-themes of identity and loss. Key findings include the diversity amongst service users accessing the service in terms of their gender, age and life stage; their motivations; the time-restricted nature of current involvement; protracted timescales from initial contact to search is not uncommon; that post-reunion social work involvement saw a marked drop from pre-contact levels, particularly for birth relatives. The study makes a compelling case for a well-resourced service that offers additional pre- and post-reunion support and argues for a more proactive professional approach, with further expansion of existing support provision.

Applicability of selected Brighton Collaboration case definitions in low-resource settings: A prospective hospital-based active surveillance in Addis Ababa, Ethiopia

IntroductionStandardizing case definitions for priority vaccine safety conditions facilitates uniform evaluation and consolidation of data obtained from different settings. The Brighton Collaboration case definitions (BCCD) were created to support this harmonization and enable classification from level 1 (most certain) to level 5 (not a case) of certainty. Assessing the performance of BCCD in practice is critical, particularly in resource-limited settings, where many new vaccines may be introduced without prior monitoring in high-income countries. We assessed the performance of BCCD in Addis Ababa, Ethiopia, as applicable to COVID-19 and other vaccines. MethodsActive surveillance was conducted at Tikur Anbessa Specialized Hospital, the largest referral hospital in Ethiopia. During June 1, 2022–May 31, 2023, three trained physicians prospectively identified patients eligible for COVID-19 vaccination (regardless of vaccine receipt) who presented with one or more of eleven pre-specified adverse events of special interest (AESI) from the emergency department and inpatient wards. Standardized data collection forms were used to capture patient information and assign level of certainty (LOC), regardless of vaccination status for COVID-19. We conducted descriptive analysis to characterize cases and the LOCs reached for each AESI. ResultsWe detected 203 AESI cases. The most detected conditions were thrombosis and thromboembolism (n = 100, 49 %) and generalized convulsions (n = 38, 19 %). Ninety-six percent of the cases were confirmed at levels 1–3 (n = 187) or level 5 (n = 9) LOC. Non-classifiable (level 4) cases were observed for pericarditis (n = 2), encephalitis (n = 2), myelitis (n = 2), and generalized convulsion (n = 1). ConclusionThe BCCD were successfully applied in > 95 % of cases in a large referral hospital in Ethiopia, with generalized convulsion, pericarditis, and encephalomyelitis as the exceptions. We recommend further evaluation in other low-resource settings, particularly in rural or non-referral hospitals, to gain additional insights into performance of these definitions for revision or adaptation, as needed.

Mindfulness-based interventions for improving mental health of frontline healthcare professionals during the COVID-19 pandemic: a systematic review

BackgroundMindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health.MethodsThe electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool.ResultsTwenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs.ConclusionsThe MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable.Systematic review registrationPROSPERO CRD42021267621

Humoral immune response and safety of Sars-Cov-2 vaccine in people with multiple sclerosis

BackgroundFor the past three years, the pandemic has had a major effect on global public health, mainly on those with underlying medical conditions, such as people living with Multiple Sclerosis. Vaccination among this group is of great importance, and the long-term impacts of vaccination and its safety on the health of these patients will continue to be revealed. Therefore, risks related to vaccination and immune response need to be assessed. The objective here was to characterize the immune response, short-term safety, and the effects of multiple variables on these factors after COVID-19 vaccination (mainly Sinopharm) among people with Multiple Sclerosis. We assessed the short-term safety and humoral SARS-COV-2 anti-RBD IgG response using a data collection form and Immunoassay, respectively.ResultsNo severe adverse events or MS relapse was observed. Myalgia/body pain (26.7%), low-grade fever (22.2%), and mild headache (15.6%) were the most common adverse events. The use and type of vaccine influenced the frequency of side effects with a p-value < 0.0001. Regarding immune response, patients on rituximab and fingolimod had a lower antibody titer compared to other medications. With a significant difference, hybrid immunity (p-value: 0.047) and type of DMTs (p-value: 0.017) affected the humoral response.ConclusionThere is a low incidence of serious adverse effects, MS worsening or relapse after COVID-19 vaccination, and mainly, side effects are similar to that of the general population. It appears that treatment with various disease-modifying therapies does not induce or worsen the post-vaccination side effects, although some, including Rituximab and fingolimod, may affect the immunity induced after vaccination.

Evaluation of future nurses' knowledge, attitudes and anxiety levels about artificial intelligence applications.

Evaluating future nurses' perspectives on artificial intelligence, determining their missing or incorrect information on the subject and determining their anxiety levels are of great importance in terms of providing science and technology-based health services in the future. This research was conducted to evaluate the knowledge, attitude and anxiety levels of future nurses about artificial intelligence applications. The research was a descriptive type, conducted with 552 nursing students. In collecting data, 'Data collection form' and 'Artificial Intelligence Anxiety Scale' (AIAS) were used. Analysis of data was performed with descriptive statistics, Kolmogorov-Smirnov, Shapiro-Wilk, Spearman, Mann-Whitney U and Kruskal-Wallis tests. In the study, p < 0.05 value was considered statistically significant. It was determined that the students' average AIAS score was 51.68 ± 12.32. It was determined that 95.3% of the students did not receive training on artificial intelligence, and 94.0% did not have artificial intelligence-related subjects in their school courses. It was determined that 79.2% of the students wanted artificial intelligence-related subjects to be included in school courses. In the study, it was determined that the artificial intelligence anxiety levels of nursing students were high. It has been determined that students with negative feelings about artificial intelligence have higher artificial intelligence anxiety levels. Our suggestion; adding courses or subjects related to artificial intelligence to the university curriculum and starting to include nurses in the working processes during their student years.

Investigation of Siblings of Patients Diagnosed with Substance-Induced Psychotic Disorder in terms of Cognitive Functions and Clinical High-Risk State for Psychosis

Objective: This study aimed to investigate the influence of familial predisposition on substance-induced psychosis among healthy siblings of patients diagnosed with substance-induced psychotic disorder, who themselves lack any family history of psychotic disorders. Additionally, the study aimed to explore clinical high-risk states for psychosis, schizotypal features, and neurocognitive functions in comparison to a healthy control group. Method: The study compared healthy siblings of 41 patients diagnosed with substance-induced psychotic disorder with 41 healthy volunteers without a family history of psychotic disorders, matching age, gender, and education. Sociodemographic and clinical characteristics of participants were obtained using data collection forms. The Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Structured Interview for Schizotypy-Revised Form (SIS-R) scales were utilized to assess clinical high risk for psychosis. Neurocognitive functions were evaluated with digit span test (DST), trail making test part A-B (TMT), verbal fluency test (VFT), and Stroop test (ST). Results: Analysis using the CAARMS scale revealed that 39% of siblings and 7.3% of the control group were at clinically high risk for psychosis, indicating a significant difference in rates of psychotic vulnerability. Comparison between siblings and the control group showed significant differences in mean SIS-R subscale scores, including social behavior, hypersensitivity, referential thinking, suspiciousness, illusions, and overall oddness, as well as in mean neurocognitive function scores, including errors in TMT-A, TMT-B, and VFT out-of-category errors, with siblings exhibiting poorer performance. Conclusion: Our study suggests that healthy siblings of patients with substance-induced psychosis exhibit more schizotypal features and have a higher risk of developing psychosis compared to healthy controls. Additionally, siblings demonstrate greater impairment in attention, response inhibition, and executive functions compared to healthy controls, indicating the potential role of genetic predisposition in the development of substance-induced psychotic disorder.

Effect of alcohol consumption on lipid profile

Now-a-days alcoholism is major complication for development of different diseases. According to our literature review chronic alcoholic consumption will cause the lot of health complications. People without any comorbidities are also diagnosed with the lot of health complications at early age because of alcohol consumption. Our aim of the study is to identify the lipid changes in chronic alcoholic patients and how it effects on their health.To monitor the lipid changes in alcoholic persons.A prospective observational study was conducted for duration of six months, the data has been collected in 456 patients over six months of period and the data was collected with informed consent from the persons. All the data was collected by interacting with persons by using data collection form and laboratory reports were studied.In our study, 456 male populations were included. Out of 456 members, 272 people were alcoholics, and 184 members were non-alcoholic. Out of 272 population 180 are chronic alcoholics and 92 are occasional alcoholics. Out of 456 members young adults (18-25) 182 (39.9%) persons and old adults (26-40) were 274 (60%) persons296 members are taking alcohol with food and 160 members are taking without food. Out of 456 population 438 (96%) persons are non-vegetarians and 18(4%) members are vegetarians. Out of 272, 104 members were drinking beer, 58 were cheap liquor, 25 were Officers' choice, 18 were royal stag, 22 were blenders pride, 15 were signature, 23 were mixed brands, and 7 were others. In our study 156 persons were drinking sweetened beverages, 52(33.3%) members are daily beverage intakes and 104(33.3%) Members are occasionally beverage intakes. According to our study most commonly used sugary beverage brands are thumps up 93(59%), 48(31%) Sting,15(10%) other sugary beverages. Out of 156, Triglycerides were elevated in 47 and LDL was elevated in 36 persons, VLDL elevated in 4 persons and T. Cholesterol elevated in 5 members, Normal lipid profile in 64 persons. Out of 456 persons, 314(69%) are undiagnosed and 142(31%) are diagnosed with lipid changes. According to our common complications associated with alcohol consumption 39 were cardiac, 56 were hepatic, 9 were renal, and 38 were others (pancreatitis, stroke, cholelithiasis).In our study, we concluded that alcohol consumption will mainly affect triglyceride levels. Elevation of triglyceride levels is associated with the quantity and duration of alcohol intake. Normal Intake of alcohol does not cause lipid changes. Excessive intake of beer and cheap liquor increases TG. Excessive alcohol intake and fat intake will increase the LDL, Triglycerides, VLDL and decrease HDL. Excessive intake of sweetened beverages may also cause dyslipidaemia. Because it contains a high number of calories. The most common complication associated with elevation of triglycerides are hypertension, cardiovascular disease. Alcohol intake with food or without food shows the same complications but the absorption of alcohol may vary with food. Alcohol consumption with fat intake will cause hyperlipidaemia.

Navigating the challenges of imposter participants in online qualitative research: lessons learned from a paediatric health services study

BackgroundThe growth in online qualitative research and data collection provides several advantages for health service researchers and participants, including convenience and extended geographic reach. However, these online processes can also present unexpected challenges, including instances of participant fraud or scam behaviour. This study describes an incident of participant fraud identified during online focus group discussions and interviews for a PhD health services research project on paediatric neurodevelopmental care.MethodsWe aimed to recruit carers of Australian children with neurodevelopmental disorders. Potential participants were recruited via a publicly available social media advert on Facebook offering $50 AUD compensation. Those who expressed interest via email (n = 254) were sent a pre-interview Qualtrics survey to complete. We identified imposters at an early stage via inconsistencies in their self-reported geographical location and that captured by the survey as well as recognition of suspicious actions before, during and after focus group discussions and interviews.ResultsInterest in participation was unexpectedly high. We determined that all potential participants were likely imposters, posing as multiple individuals and using different IP addresses across Nigeria, Australia, and the United States. In doing so, we were able to characterise several “red flags” for identifying imposter participants, particularly those posing as multiple individuals. These comprise a combination of factors including large volumes and strange timings of email responses, unlikely demographic characteristics, short or vague interviews, a preference for nonvisual participation, fixation on monetary compensation, and inconsistencies in reported geographical location. Additionally, we propose several strategies to combat this issue such as providing proof of location or eligibility during recruitment and data collection, examining email and consent form patterns, and comparing demographic data with regional statistics.ConclusionsThe emergent risk of imposter participants is an important consideration for those seeking to conduct health services research using qualitative approaches in online environments. Methodological design choices intended to improve equity and access for the target population may have an unintended consequence of improving access for fraudulent actors unless appropriate risk mitigation strategies are also employed. Lessons learned from this experience are likely to be valuable for novice health service researchers involved in online focus group discussions and interviews.

MEDICAL STORE MANAGEMENT AT ABVGMC VIDISHA (MP): AN ANALYSIS AT TERTIARY CARE HOSPITAL

Objective: The objective of this study was to perform a qualitative and quantitative comparison of the practice and infrastructure with applicable legislations governing hospital pharmacy while the secondary objective was to calculate the average dispensing time of a prescription in the hospital pharmacy. Methods: Our hospital was established in 2018. A prospective cross-sectional analytic study was carried out in the hospital pharmacy for 6 months (January 23–June 23). A blend of quality control parameters was drafted after referring various guidelines put forward by the statutory bodies. Qualitative data were collected by continuous observation, physical inspection, and after a thorough interview of hospital pharmacists. The collected data were summarized and compared with the standards. Quantitative data on the minimum requirement of hospital pharmacy infrastructure and dispensing time were collected using the designed data collection form and analysis was performed. Results: The hospital pharmacy met all the criteria that are necessary to satisfy legal requirements, availability of medicine, medicine, and general safety, and most of the quality parameters. However, few deviations were observed in the management of the drug store. The shortage in the floor space and waiting area was identified. In the study, we find that the average waiting time for the patient at the drug distribution center is 180 s and the average drug dispensing time was 130 s. On the basis of our good working in pharmacy, we got NABH approval in 2023 which includes pharmacy with other departments of this hospital. Conclusion: Majority of the quality parameters were noted to be compliant with the standards. Few deviations were identified and measures to improve them were suggested.

Lost years, mortality burden: the impact of COVID-19 pandemic on premature death due to road traffic accidents in a northern state in Malaysia

BackgroundThis study addresses the persistent global burden of road traffic fatalities, particularly in middle-income countries like Malaysia, by exploring the impact of the COVID-19 pandemic on Road Traffic Accident (RTA) fatalities in Perak state, Malaysia, with a secondary focus on applying Years of Life Lost (YLL) to understand the implications of these premature deaths.MethodologyThe cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia.ResultsThis study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018–2019) and pandemic years (2020–2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30–34 during the pandemic.ConclusionThe decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.

An application (ePRO) -based patient reported outcomes of quality of life from an innovative cancer care delivery model.

e23176 Background: With the accessibility of smartphones, it has become possible to develop applications for patient-reported outcomes. Quality of life (QoL) is an important measure in oncology research. We developed a phone application that could use any standardized form to be filled in by the patient. Here, we report using the EORTC questionnaire, QLQ-C30, built into the application as a form for data collection from our ongoing district cancer care program, which offers support at government district hospitals in India using an alternate oncology work force. Methods: An application (ePRO) was created, which allows one doctor administrator to follow the patients. Once the application is downloaded, the patient opens the QoL questionnaire (QLQ-C30), built into the application, and completes it using a smartphone. The researcher downloaded the data in Excel format and analyzed it. The application was attempted at a tertiary cancer center and a public hospital district cancer unit. A cross-sectional study was conducted over six months in 2023.The data were analyzed using SPSS version 24. Results: The application was downloaded and activated on the smartphones of 441 patients. Patients completed the form available through the application. Of all the respondents, 229 (51.9%) were male and 212 (48.1%) were female. The mean QoL of the tertiary hospital was 69.29, with a standard deviation (SD) of 18.98.The QoL scores were 50.94 (SD 23.50) in district hospital 1 and 77.01 (SD 17.35) in district hospital 2. The difference between one district and the other was significant (p &lt; 0.001). The symptom scale scores varied between district hospitals and other hospitals. Conclusions: This presentation serves two purposes: to validate a new patient-reported outcome application and to provide data on QoL from peripheral centers compared with tertiary centers. The use of technology is feasible and can help gather patient-reported outcomes easily. There appears to be a difference in the quality of life of patients from different geographical locations. [Table: see text]

Potret Negara Totaliter dalam Novel Bungkam Suara karya J. S. Khairen

This research is conducted to describe the portrait of totalitarian state in Bungkam Suara by J.S. Khairen which is released in January 2023. The story of the novel is about a fiction state called Negara Kesatuan Adat Lawaknesia (NKAL) which is not detected by world map and assumed that no other world but theirs. This research is focus to the portrait of totalitarian state and how NKAL’s citizen respond the government in Bungkam Suara by J.S. Khairen. This research is a qualitative using a descriptive methods. The data were conducted by reading the novel intensively, marking the dialogues and narratives, and inventory the data in the data collection form using smartphone, desktop, and data collection form. The results of this research is revealing that, first, there are 3 of 4 characteristics of totalitarian state (by Hannah Arendt) that found in NKAL; (a) dictatorship; (b) propaganda; (c) terror. There are one characteristic that not found in NKAL is indoctrination. Second, NKAL’s citizen respond the government is civil disobedience that fulfilled all the condition; (a) prudence; (b) communication; (c) publicity; and (d) nonviolence.

CONTINUITY OF CARER: WHAT DOES IT MEAN AND DOES IT MATTER TO MIDWIVES AND BIRTHING WOMEN?

This paper discusses key themes from a large-scale, long-term multi-perspective evaluation of caseload midwifery practice in the United Kingdom (UK). Caseload practice was introduced in several UK settings, on a pilot scale, following the publication of Changing Childbirth intended to put into practice its core principles of continuity, choice and control for women.1 A range of new midwifery practices were piloted and evaluated across the UK. Relatively little attention was given to defining and exploring the nature and meanings of the new models of practice, or to midwives in this new practice context. This has led to difficulty in comparing the impact of different models of practice. We draw on two aspects of our work – an ethnographic study of the experiences of midwives (with and without caseloads) and a study of the women's experiences and responses to care – to explore in greater depth the concepts involved in the caseload model and their meaning for women and for midwives in practice. Interviews were conducted with 40 women and 36 caseload midwives. Other forms of data collection, including questionnaires and observation were used and were analysed thematically using grounded theory principles. Themes emerging included autonomy, confidence, reciprocity and relationship: the idea of knowing and being known. On this basis we have argued that continuity is not an end in itself but an important means towards the end of women-centred care and should be considered in relation to other key themes such as autonomy and environment.

Hospital Managers' Decision-Making Puzzle.

Decision-making is choosing one option from among different options. Most decision-making models were developed in the general industry. Specific decision-making models are needed due to the special nature of the hospital and its services. We aimed to propose and validate a decision-making model for hospital managers. This research used the modified Delphi technique to develop and validate a decision-making model for hospital managers. A data collection form was used to collect data. The search of English databases covered the period from 1990 to 2020. The first draft of the model was introduced through a scoping review and semi-structured interviews. Two rounds of Delphi were conducted with 33 experts to verify the proposed model. Many factors affect the quality and outcome of a hospital manager's decision. The decision-making model developed in this study has 10 constructs grouped into three components (i.e., inputs, processes, and outputs). These constructs include decision maker, decision implementer, organization, client, subject, analysis, identification, evaluation & selection, implementation and control. This model provides a guide for each decision stage and determines the conditions necessary for a good decision. Using the decision-making puzzle and considering the set of inputs, processes, and outcomes of the decision making together alongside with specifying the details of each decision-making stage make it easy for hospital managers to decide. Such a scientific, objective and systematic approach in decision-making will result in desired results for staff, patients, managers and the hospital. This puzzle is also a good tool for pathology of hospital managers' decisions.

Cyber Risk Assessment Framework for the Construction Industry Using Machine Learning Techniques

Construction 4.0 integrates digital technologies that increase vulnerability to cyber threats. A dedicated cyber risk assessment framework is essential for proactive risk mitigation. However, existing studies on this subject within the construction sector are scarce, with most discussions still in the preliminary stages. This study introduces a cyber risk assessment framework that integrates machine learning techniques, pioneering a data-driven approach to quantitatively assess cyber risks while considering industry-specific vulnerabilities. The framework builds on over 20 literature reviews related to construction cybersecurity and semi-structured interviews with two industry experts, ensuring both rigor and alignment with practical industrial needs. This study also addresses the challenges of data collection and proposes potential solutions, such as a standardized data collection format with preset fields that computers can automatically populate using data from construction companies. Additionally, the framework proposes dynamic machine learning models that adjust based on new data, facilitating continuous risk monitoring tailored to industry needs. Furthermore, this study explores the potential of advanced language models in cybersecurity management, positioning them as intelligent cybersecurity consultants that provide answers to security inquiries. Overall, this study develops a conceptual machine learning framework aimed at creating a robust, off-the-shelf cyber risk management system for industry practitioners.

Injury patterns in motor vehicle collision–youth pedestrian deaths

Objective The objective of this study was to describe fatal pedestrian injury patterns in youth aged 15 to 24 years old and correlate them with motor vehicle collision (MVC) dynamics and pedestrian kinematics using data from medicolegal death investigations of MVCs occurring in the current Canadian motor vehicle (MV) fleet. Methods Based on a systematic literature review, MVC–pedestrian injuries were collated in an injury data collection form (IDCF). The IDCF was coded using the Abbreviated Injury Scale (AIS) 2015 revision. The AIS of the most frequent severe injury was noted for individual body regions. The Maximum AIS (MAIS) was used to define the most severe injury to the body overall and by body regions (MAISBR). This study focused on serious to maximal injuries (AIS 3–6) that had an increasing likelihood of causing death. The IDCF was used to extract collision and injury data from the Office of the Chief Coroner for Ontario (OCCO) database of postmortem examinations done at the Provincial Forensic Pathology Unit (PFPU) in Toronto, Canada, and other provincial facilities between 2013 and 2019. Injury data were correlated with data about the MVs and MV dynamics and pedestrian kinematics. The study was approved by the Western University Health Science Research Ethics Board (Project ID: 113440; Lawson Health Research Institute Approval No. R-19-066). Results There were 88 youth, including 54 (61.4%) males and 34 (38.6%) females. Youth pedestrians comprised 13.1% (88/670) of all autopsied pedestrians. Cars (n = 25/88, 28.4%) were the most frequent type of vehicle in single-vehicle impacts, but collectively vehicles with high hood edges (i.e., greater distance between the ground and hood edge) were in the majority. Forward projection (n = 34/88, 38.6%) was the most frequent type of pedestrian kinematics. Regardless of the type of vehicle, there was a tendency in most cases for the median MAISBR ≥ 3 to involve the head and thorax. A similar trend was seen in most of the pedestrian kinematics involving the various frontal impacts. Of the 88 cases, at least 63 (71.6%) were known to be engaged in risk-taking behaviors (e.g., activity on roadway). At least 12 deaths were nonaccidental (8 suicides and 4 homicides). Some activities may have been impairment related, because 26/63 (41.3%) pedestrians undertaking risk-taking behavior on the roadway were impaired. Toxicological analyses revealed that over half of the cases (47/88, 53.4%) tested positive for a drug that could have affected behavior. Ethanol was the most common. Thirty-one had positive blood results. Conclusion A fatal dyad of head and thorax trauma was observed for pedestrians struck by cars. For those pedestrians hit by vehicles with high hood edges, which were involved in the majority of cases, a fatal triad of injuries to the head, thorax, and abdomen/retroperitoneum was observed. Most deaths occurred from frontal collisions and at speeds more than 35 km/h.

Prevalence and factors associated with medication administration errors in the neonatal intensive care unit: A multicentre, nationwide direct observational study.

To determine the prevalence of medication administration errors and identify factors associated with medication administration errors among neonates in the neonatal intensive care units. Prospective direct observational study. The study was conducted in the neonatal intensive care units of five public hospitals in Malaysia from April 2022 to March 2023. The preparation and administration of medications were observed using a standardized data collection form followed by chart review. After data collection, error identification was independently performed by two clinical pharmacists. Multivariable logistic regression was used to identify factors associated with medication administration errors. A total of 743 out of 1093 observed doses had at least one error, affecting 92.4% (157/170) neonates. The rate of medication administration errors was 68.0%. The top three most frequently occurring types of medication administration errors were wrong rate of administration (21.2%), wrong drug preparation (17.9%) and wrong dose (17.0%). Factors significantly associated with medication administration errors were medications administered intravenously, unavailability of a protocol, the number of prescribed medications, nursing experience, non-ventilated neonates and gestational age in weeks. Medication administration errors among neonates in the neonatal intensive care units are still common. The intravenous route of administration, absence of a protocol, younger gestational age, non-ventilated neonates, higher number of medications prescribed and increased years of nursing experience were significantly associated with medication administration errors. The findings of this study will enable the implementation of effective and sustainable interventions to target the factors identified in reducing medication administration errors among neonates in the neonatal intensive care unit. We adhered to the STROBE checklist. An expert panel consisting of healthcare professionals was involved in the identification of independent variables.

The prevalence and severity of upper gastrointestinal complications among patients with chronic diseases: a cross-sectional study from Palestine

BackgroundMany old people have at least one chronic disease. As a result, multiple drugs should be used. Gastrointestinal complications may occur because of the harmful effects of these chronic drugs on the stomach. The study aimed to assess the prevalence of upper gastrointestinal complications in patients taking chronic medications, the severity of these symptoms, and whether they take any gastro-protective drugs or not.MethodologyThis was a cross-sectional study through face-to-face questionnaires from internal outpatient clinics at a specialized hospital. Patients with chronic diseases who were taking at least one chronic medication were included in the study. Data Collection Form was used to gather information. The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was used to evaluate the severity of the upper gastrointestinal symptoms. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21.ResultsA total of 400 patients with chronic diseases and using multiple medications were included. Among them, 53.8% were females and 56% were married, 58.5% were unemployed, 70% were not smokers, the mean age was 54.7 ± 17.5 years. The most common comorbid diseases among the patients were diabetes, hypertension, and arthritis, with percentages of 44.3%, 38%, and 27.3%, respectively. The mean number of chronic medications used was 3.36 ± 1.6 with a range of 1 to 9. The most commonly used was aspirin with a percentage of 50%, followed by atorvastatin, bisoprolol, and insulin with percentages of 29.5%, 25%, and 20.3%, respectively. Among the 400 participants, 362 (90.5%) suffered from upper gastrointestinal side effects like indigestion (65.8%), heartburn (78.3%), nausea (48.8%), and regurgitation (52.0%). Based on SF-LDQ scoring, of the 400 respondents, 235(58.8%), 109(27.3%) and 18(4.5%) suffered from mild, moderate and severe dyspepsia, respectively. A high percentage 325 (81.3%) of participants were prescribed gastro-protective medications. Proton pump inhibitors were the most prescribed group in 209 (52.3%) patients. Dyspepsia was significantly associated with older age (p-value = 0.001), being educated (p-value = 0.031), not being single (p-value < 0.001), having health insurance (p-value = 0.021), being a smoker (p-value = 0.003), and using ≥ 5 medications (p-value < 0.001).ConclusionUpper gastrointestinal complications among patients with chronic diseases were very common. Fortunately, the symptoms were mild in most cases. The risk increased with age and using a higher number of medications. It is important to review patients’ medications and avoid overuse of them, in addition to use gastro-protective agents when needed.