Good Guidelines Research Articles

CROSS-CULTURAL ADAPTATION AND VALIDATION TO SPANISH OF THE PANELVIEW INSTRUMENT TO EVALUATE THE HEALTH GUIDELINES DEVELOPMENT PROCESS

The PANELVIEW questionnaire identifies the strengths and weaknesses of the process and methods used for developing health guidelines from the guideline development group's perspective. To expand its use, PANELVIEW ideally should be available in different languages. We aimed to cross-culturally adapt PANELVIEW into Spanish and assess its acceptability, validity, and reliability. To translate and culturally adapt PANELVIEW to Spanish, we followed ISPOR's Translation and Cultural Adaptation Good Practice Principles guidelines. The process consisted of 1) forward and back translation, 2) input from an expert panel, and 3) cognitive debriefing interviews. We assessed the content validity with experts in guideline development who rated instrument items for relevance to determine the item and scale content validity index (I-CVI; S-CVI). We tested the reliability with health guidelines panels from Spanish-speaking countries and measured internal consistency (Cronbach's alpha). We examined acceptability through the number of missing responses for each item. The content comparison between the back-translation and the original version showed that most items (24/34) were conceptually equivalent but with grammatical differences. Through the cognitive interviews, we identified six items with wording issues, ten with clarity issues, and two with applicability issues. I-CVI ranged from 0.77 to 1.00, with two items needing revision. S-CVI was 0.92, showing excellent content validity. The PANELVIEW Spanish version demonstrated very good reliability (Cronbach's alpha coefficient of 0.96). Panel members responded to all items, showing good acceptability. The PANELVIEW Spanish version was conceptually equivalent to the original version and provided satisfactory evidence of acceptability, validity and reliability.

From gender policies and practices to organisational performance of sport governing bodies

ABSTRACT Research question Gender policies reflect identity-conscious human resource management structures that aim to reduce unfair treatment based on gender. Drawing on signalling theory and the categorisation-elaboration model, the literature suggests that the relationship between gender policies and organisational performance is moderated by several factors (gender practices, organisational culture, decision-making quality), which have not yet been empirically studied. The purpose of this study is to investigate the presence of gender policies in sport governing bodies (SGBs) and examine their relationship with organisational performance. Research methods An online questionnaire was sent to representatives of German SGBs (n = 202). Structural equation modelling was used to examine the relationships between gender policies, gender practices (i.e. board gender diversity), organisational culture, decision-making quality, and organisational performance. Results and findings Gender policies are rarely present in German SGBs, and can only shape the organisational culture when they are connected to daily routines (in contrast to the simple presence of a written statement). Gender policies and practices are positively associated with decision-making quality and organisational performance. Implications The findings contribute to the literature by shedding light on the theoretical mechanisms (i.e. organisational culture, decision-making quality) through which group diversity affects organisational performance. Sport managers should connect gender policies to the daily work instead of simply including them in good governance guidelines, especially because they also benefit the organisation in terms of better performance. Politicians should consider mandatory regulations to make gender policies more effective.

Assessing Sustainability Performance at Farm Level in the Kingdom of Bahrain

Crop production in Bahrain is facing many challenges that may undermine farm's sustainability. Farmers are an important player and assessing farm’s sustainability to identify performance gaps is essential. This study aims to measures farm sustainability in Bahrain using Response-Inducing Sustainability Evaluation (RISE) tool accompanied by field visit observations. The assessment was carried out on 29 farms and applied on 8 themes. The study contributed by configuring RISE's regional data to match Bahrain's conditions through the adjustment of some evaluation functions. The application of RISE showed that the average score of the 29 farms was (63 points) which indicates the requirement of additional improvement. Farms fared well in five themes (quality of life, water use, working conditions, soil use, and farm management). Whereas it performed low in three themes (Material Use, Biodiversity & Economic viability). Quality of life theme received the highest score (76 points), while biodiversity was the lowest (34 points). RISE application was successful; however, land tenure needs to be considered to improve local sustainability. Despite the presence of lands that are classified as agriculture but unexploited, it is suggested to encourage landowners exploiting the lands or rent them out to other farmers. In addition, the development of good agricultural practises guidelines is vital.

Update on systemic sclerosis

The updates to the European recommendations and the German guidelines for the treatment of systemic sclerosis are expected shortly, which are very good evidence-based guidelines for all those treating the disease; however, there are still disease manifestations with insufficient studies and current study results that were published after the review of the literature for the guidelines and might be of interest to the reader. The aim of this work is to provide an overview of the publications in the last year that are interesting from the authors' point of view. The aim is to provide practically relevant information on the current state of knowledge that can supplement the guidelines. The pathogenesis of systemic sclerosis (SSc) is becoming better understood in its interplay between environmental factors and the development of autoantibodies. There have also been overviews of the manifestation and prognosis of cardiac involvement in the last year. The American Thoracic Society issued the first guidelines for the treatment of interstitial lung disease in SSc. There are an increasing number of studies that suggest that disease-modulating combination therapies, such as rituximab and mycophenolate mofetil (MMF) are beneficial. Work addressing the involvement of joints suggests that inflammatory changes are common. Current options for the treatment of gastrointestinal involvement are presented. The diagnosis and treatment of systemic sclerosis is making progress and many symptoms and complications are treatable. Nevertheless, much remains to be done to improve the quality of life of the patients.

Food Allergy Awareness Champions: Improving Food Safety Standards in Online Food Procurement for People With Food Hypersensitivities

Background There have been changes more recently in how people commonly acquire and consume food at home. The practice of ordering online food delivery including ready-to-eat meals, drinks, and snacks has increased immensely. The COVID-19 pandemic has likely been a factor in this change in practice as it’s now the case that one in four consumers thinks about using meal delivery services on a regular basis. The aims of this project were: • to improve understanding and knowledge of the behaviours of FHS citizen scientists buying ready-to-eat (takeaway and delivered) food online. • to learn more about the visible procedures and practices of individual food businesses offering online food delivery. • to use accredited methods to determine the presence of certain allergens in selected samples of food procured by participants. Results In general, respondents expressed more trust in nationwide food chains due to their perceived resources, updated information, menu consistency and/or accreditation by a UK allergy charity, such as Allergy UK or Coeliac UK. The citizen scientists revealed some of their behaviours to minimise the risk of contamination including: • eating food alone, before or after the family or work meal • physically separating gluten-containing from non-gluten-containing foods at the table • double checking the food order and the labels provided • following good food hygiene guidelines • using their own senses. Furthermore, there were some indications that older FHS citizens may perceive the risk of ordering online differently from younger age groups.

District heating utilizing waste heat of a data center: High-temperature heat pumps

Data centers are energy-intensive facilities with substantial low-grade waste heat. High-temperature heat pumps can be critical in boosting the data center’s waste heat for district heating, improving the system-level energy efficiency of data centers, and reducing CO2 emissions in district heating. This study built thermodynamic models to assess high-temperature heat pumps with six configurations using low global warming potential refrigerants to supply heat up to 120 °C. The heat pump configurations include single-stage or two-stage cycles with advanced components, such as internal heat exchanger, economizer, flash tank, or parallel compressor. The refrigerants include R1234ze(Z), R1233ed(E), R1224yd(Z), R600, and R600a, and R245fa is used as a reference. A case study was carried out to recover the waste heat from the Frontier high-performance computing data center and provide hot water for district heating at the US Department of Energy’s Oak Ridge National Laboratory campus. The optimized performance of high-temperature heat pumps is characterized with various effectiveness of internal heat exchangers, and the operating parameters of economizer or flash tank, as well as their combination. The results show that the configurations of two-stage cycles with internal heat exchanger + flash tank and internal heat exchanger + economizer/parallel-compressor provide the highest coefficient of performance under scenarios of the maximum allowable value and a fixed value (0.3) of the internal heat exchangers’ effectiveness, respectively. R1234ze(Z) and R600a are the most promising refrigerants, considering trade-offs between the coefficient of performance and the volumetric heating capacity. The single-stage cycle with internal heat exchanger + economizer/parallel-compressor using R1234ze(Z) is recommended for utilizing Fronter’s waste heat in district heating. A one mega-watt high-temperature heat pump will reduce 33,100–33,200 metric tons of CO2 emission annually, corresponding to 85.4 %–85.6 % of equivalent CO2 emissions from natural gas boilers. This study provides good guidelines for designing and deploying high-temperature heat pumps to support sustainable data centers and decarbonize district heating in the US.

Mitigating data imbalance and generating better prototypes in heterogeneous Federated Graph Learning

Federated Graph Learning (FGL) opens up new possibilities for machine learning in complex networks and distributed training, enabling multiple clients to collaborate on training Graph Neural Networks (GNNs) while preserving privacy. However, there may be differences between participating clients in terms of data distribution, computational power, and model architecture, which requires us to be able to mitigate the problem of heterogeneity across participating clients. Most of the existing model-heterogeneous Federated Learning frameworks are based on non-graph data, which is not sufficiently effective in FGL scenarios. Moreover we find that the model-heterogeneous Federated Learning approach based on prototype learning generates a single global prototype that does not provide good guidelines for each client in the case of multiple heterogeneous clients. Also, the problem of class imbalance of local data in FGL scenarios affects the overall utility. To this end, we propose FGPL, a model heterogeneous FGL framework based on prototype learning and local data augmentation. Specifically, on the one hand, locally, we mitigate the problem of local data imbalance by generating better local prototypes through a node generation method based on global prototypes and local structures. On the other hand, we cope with the domain bias problem by generating targeted global prototypes, and use a comparative learning approach to provide more personalized and correct guidelines for each client’s training. We demonstrate with extensive experiments that our approach can greatly improve the prediction of FGL. The code associated with this study is available at https://github.com/1447884149/FGPL.

A Deep Learning-Based Teaching Design for High School Geography Units: Taking the Example of Landforms of the Humanistic Education Edition

The traditional teaching methods of one-way cultivation of students can no longer meet the requirements oftalent cultivation at this stage. The issue of how to promote students from passive acceptance to the independent cognitive understanding stage (i.e. deep learning) has become the focus of geography teaching. Therefore, under the guidance of deep learning theory, this paper takes the “landforms” knowledge unit of the Humanistic Education Edition as an example, improves the classroom teaching means through the unit teaching mode, reconstructs the “landforms” teaching unit, and explores the specific teaching of high school geography unit based on deep learning. This study provides a good example and guidelines for high school geography teaching and learning.

Bridges in small basins with intense sediment transport and debris flow

In Italy a significant part of the bridge collapses are due to hydraulic causes. Despite this, the Italian technical construction standards NTC 2018 provide few indications about the design and verification criteria of bridges with respect to river processes. In 2022, a working group on the "Hydraulic Compatibility of Bridges" (sites.google.com/view/gii-ponti) was set up within the Italian Group of Hydraulics (GII - Gruppo Italiano di Idraulica), with the aim of formulating proposals for good practices and guidelines for assessing the bridge hydraulic compatibility, as a basis for both bridge safety and flood risk analysis. The working subgroup on "small basins" aims to provide analysis tools for small river basins: they have peculiar features, requiring the adoption of appropriate criteria for the analysis of forcing scenarios and safety measures to be implemented for the hydraulic compatibility of river-crossing bridges. Particular attention is devoted to climatic changes that, although gradual, can induce strongly non-linear responses. The present manuscript reviews the current best practice for analyzing the hydrologic response, the sediment balance, the flow propagation and the dynamic impact force against bridges in the case of mountain basins, pointing out limitations and possible future developments required in order to develop guidelines for bridge safety and flood hazard assessment.

Formation of wood obstructions at bridges: processes, related problems and prediction tools

The primary cause of many bridge collapses is related to hydraulic issues, and the Italian technical standards for constructions (NTC 2018) offer limited guidance on the design and verification criteria for bridges, especially concerning river processes. Recognizing this gap, a working group dedicated to ‘Hydraulic Compatibility of Bridges’ (sites.google.com/view/gii-ponti) was established in 2021. The group’s objective is to develop proposals for good practices and guidelines that assess bridge hydraulic compatibility, providing a foundation for both bridge safety and flood risk analysis. Within this initiative, a working subgroup focused on ‘floating debris’ is striving to define a methodology for assessing the impacts of wood accumulation on bridges. While wood in rivers is environmentally beneficial, its transport and accumulation at bridges during high-stage events can lead to problematic consequences. Over the past two decades, the scientific community has actively studied wood transport dynamics, accumulation formation at bridges, and their effects on hydraulics and structural stability. Although some methodologies to assess wood-related risk have been incorporated into national legislation or practitioner reports, these implementations vary widely in defining the shape of accumulation, the wood volume assessment and the number of parameters considered. In many cases, qualitative evaluations are used for estimation due to the complexity and high site specificity inherent in wood transport dynamics. This work aims to propose a comprehensive approach, based on the latest research findings, (i) to define the wood accumulation probability at a bridge, (ii) to estimate the size and position of the accumulation, and (iii) to suggest a methodology for the estimation of bridge scour induced by wood accumulation.

Strategy for Teachers Management in Binhai School in Xiashan District, Zhanjiang

Focusing on teacher management in private basic education schools in China, this paper makes it clear that the stable development of teachers, as the core resources of the school and the sowers of human civilization, is crucial to the sustainable development of private schools. The authors emphasize that for private schools to achieve long-term development, it is essential to build a team of teachers with strong professional competence and high business standards. Problems in teacher management include insufficient talent pool, unstable team building, unfair salary and remuneration, and unstandardized management system, which originate from the government and social environment as well as the school’s own management level. This article proposes guiding principles for teacher management, which are mainly divided into four aspects: teacher tenure system, teacher training system, teacher incentive mechanism and teacher evaluation system. The article concludes that teachers determine the quality of education and the quality of talents produced, and that private schools must develop good guidelines for teacher management in order to achieve sustainable development. For private schools, teacher management is a project that requires long-term persistence and systematic practice, involving various aspects of work. Given the limited number of years available for the study, it is recommended that guidelines for medium- and long-term teacher management in private basic education schools be further explored in the context of teacher development planning.

Construction of moral education according to Hamka in Al-Azhar commentary

Moral (akhlak) education is an important thing in education that aims to create children with good and noble character. The problems that many children do are acts of violence, lying, seeking, drugs, and so on. It is necessary to provide proper education so that children have good principles or guidelines in their lives. This study aims to find out the contents of moral (akhlak) education in Al-Qur'an, especially Luqman verses 12-19. This study was a library research. The data sources used included various kinds of literature such as books, Al-Azhar commentary book and scientific journals related to the study topic. The content of the educational material involved here was regarding the role of parents in family education contained in Surah Lukman verses 12-19 according to Hamka's commentary in Al-Azhar Commentary. The authors found and analysed several points, namely teaching about instilling monotheism, being grateful, devoted to both parents, istiqomah in goodness, upholding prayers, amar ma'ruf nahi mungkar, being patient in facing trials, being simple in life, and polite in communicating.

Di-chlorinated benzothiadiazole unit: a new strong electron-withdrawing ability acceptor toward fast-switching green low band gap D-A electrochromic polymers

Di-halogenated benzothiadiazole (BT) is one of the potential acceptor units in constructing low band gap d-A polymers, but it has not attracted widespread attention, especially for the di-chlorinated BT unit. Herein, in this work, two kinds of d-π-A-π-D electrochromic conjugated precursors with di-halogenated BT (5,6-dichlorobenzo[c][1,2,5]thiadiazole and 5‑chloro-6-fluorobenzo[c][1,2,5]thiadiazole) as the acceptor unit, 3-dodecyl thiophene as the π bridge, and 3,4-ethylenedioxythiophene (EDOT) as the donor unit, were designed and synthesized, and their corresponding d-A polymers were successfully obtained by electrochemical deposition method. The photophysical study proves that introducing more chlorine atoms among the precursors will lead to stronger steric hindrance, lower HOMO energy level, blue-shifted absorption spectra, lower quantum yield, but larger Stokes shift. Both of them show very low oxidation potential, which is beneficial for them to obtain high-quality d-A polymers. The introduction of di-chlorinated BT unit obviously improved the polymers’ electroactivity and redox stability, and the remained activity of P(ClCl) was above 74.79 after 1000 cycles. The optical band gap of P(ClCl) is further reduced to 1.28 eV, and the reversible transition from the neutral dark green to the oxidized dark blue can be realized in the redox process. As a result, various favorable electrochromic parameters for P(ClCl) were achieved, such as the optical contrast in the near-infrared region is 27.23 %, the response time is as low as 0.4 s, and the coloration efficiency is as high as 151.3 cm2 C−1, as well as the good optical stability and satisfied memory effect. Overall, the subtle change of halogen atoms in BT units is a very efficient method to modulate the photophysical properties of d-π-A-π-D precursors, also providing good guidelines in designing highly efficient d-A electrochromic polymers.

A review of knowledge, attitudes and practices regarding mosquitoes and mosquito-borne infectious diseases in nonendemic regions.

Mosquito-borne infectious diseases (MBIDs) present significant public health risks within tropical and subtropical regions. However, the rapid spread of MBIDs from these areas to temperate regions increase the risk of their emergence in nonendemic regions, i.e., regions where diseases are still sporadic and not sustained in the population. Raising awareness about preventive measures and protective behaviors is of primary importance to face the risks of vector-borne diseases. In this context, the number of studies on knowledge, attitude, and practice (KAP) about mosquitoes and MBIDs has grown rapidly in response to the need to identify knowledge and practices in nonendemic countries to fight mosquito proliferation. Building upon the recent developments in this field, we conducted the first-ever literature review to examine KAP studies conducted in nonendemic regions. Our aim was to identify the community's knowledge and attitudes that shape practices concerning the prevention of MBIDs. We used specific keywords regarding the scope of this review and then selected studies that were performed in nonendemic regions for MBIDs, including regions located in European countries, the USA or Asia. We identified 32 KAP studies, the oldest from 2003. The findings in the reviewed studies show that survey participants generally possessed a rather good understanding of mosquito breeding sites. However, there were notable variations in knowledge and perception of MBIDs, primarily linked to the geographic location of the survey and the prevalence of infectious outbreaks related to mosquito transmission. These findings highlight the significant influence of knowledge and awareness in fostering effective mosquito control practices. Moreover, socioeconomic status, particularly educational attainment, and respondents' gender emerged as key determinants in explaining the variability of appropriate practices. The survey results thus show the crucial role of knowledge, emphasizing the need for widespread awareness and information campaigns, encompassing both appropriate practices and efficient mosquito control methods. Understanding the interaction between these factors could provide good guidelines for implementing awareness plans and ultimately motivate the population to actively fight against mosquito proliferation and MBIDs development.

Screening for quality with process analytical technology in a health-system pharmacy: A primer.

The University of Kentucky Drug Quality Study team briefly reviews the growing concerns over pharmaceutical manufacturing quality in the globalized environment, reviews the historical approach by the US Food and Drug Administration (FDA) that prioritizes process over product in enforcing quality with manufacturers, reviews the science of process analytical technology (PAT) such as near-infrared (NIR) spectroscopy, illustrates the use of PAT methods for assessing uniformity and quality in injectable pharmaceuticals, and demonstrates the application of NIR spectroscopy in a health-system pharmacy setting while maintaining current good practice quality guidelines and regulations (cGxP). Given that the current approach to monitoring quality in pharmaceutical manufacturing was developed in the late 1960s at a time when manufacturing was mostly domestic, the current approach prioritizes process over product, and the global footprint of manufacturing is straining federal resources to fulfill their task of monitoring quality, an approach to augment the quality monitoring process has been developed. PAT methodologies are supported by FDA for monitoring quality and offer a fast, low-cost, nondestructive solution. Given that the Accreditation Council for Pharmacy Education has not required qualitative/quantitative analysis and drug assaying in the pharmacy curriculum for several decades, the authors spend time explaining the science behind one of these PAT methodologies, NIR spectroscopy. This primer reviews the application of this technology in the health-system pharmacy setting and the relevant clinical applications. Utilizing PAT methodologies such as NIR spectroscopy, health-system pharmacies can gain insights about whether process controls are in place or lacking in FDA-approved formulations.

Farmers’ perceptions of severe climate risks and adaptation interventions in indigenous communities in northern Ghana

Perceptions of climate change are widely studied and documented. However, understandings of conceptions and experiences of severe climate risks in indigenous farming communities are insufficient. This research respond to that knowledge gap with evidence from selected indigenous farming communities in northern Ghana through a mixed-method approach. Results from the empirical data show that farmers perceive severe climate risk to mean livelihood disruption throughout the season, unproductive farmlands, ineffective adaptation and inability to break even. The logistic regression estimates show that gender, marital status, livelihood activity and ecological zone are all influential factors that are likely to predict farmers’ perceptions of severe climate risk. Farmers in northern Ghana experience severe physical climate risks such as extreme droughts, extreme temperatures, severe heatwaves, frequent floods and severe water stress. To mitigate severe physical climate risks and disasters, individual farmers implement indigenous adaptation strategies such as livelihood diversification, construction of hand-dug wells in farms, migration, building of mounds or ridges, and early marriage of young girls. Collectively, farming communities culturally utilize animal sacrifices and spiritual incantations to invoke rains to address prolonged droughts. Understanding severe climate risks and their determinants will provide good policy guidelines for early warning systems to sustainably improve livelihood and food security in resource-constrained communities.

Spatial patterns through diffusion-driven instability in modified predator–prey models with chaotic behaviors

Understanding the connection between spatial patterns in population densities and ecological heterogeneity is significant to the understanding of population dynamics and the governance of species in a given domain. In this paper, the spatiotemporal complexity of prey–predator dynamics with fractional Laplacian derivative and migration is investigated. To provide good guidelines on the choice of parameters, the linear stability analysis of the models was investigated. The fractional Laplacian operator was defined in terms of the left- and right-handed Riemann–Liouville derivative which in turn were approximated by using the fourth-order compact difference scheme, and the resulting system of ODEs was advanced in time using the fourth-order exponential time-differencing Runge–Kutta method. In the simulation experiments, different Turing dynamics such as spots, stripes, and other chaotic patterns are observed. Overall, pattern formation in predator–prey models is useful for understanding the dynamics of ecological systems, predicting the long-term behavior of the system, and studying the impact of environmental factors on the dynamics of the system.

Pathogenic Bacterial Communities Isolated and Identified in Stingless Bee (Kelulut) Honey from Selected Farms in Terengganu

In Malaysia, stingless bees can be categorised into two genera: Melipona and Trigona, known as “kelulut”. The high demand for kelulut honey boosts the production of the honey industry. Previous studies reported that stingless bee (kelulut) honey and its products were contaminated with pathogenic bacteria during harvesting and processing. This research aims to isolate and identify the pathogenic bacteria in kelulut honey. Forty-eight samples of kelulut honey (open and closed pot) and propolis were obtained from selected farms in Terengganu by focusing on a major stingless bee species available in Malaysia, Heterotrigona itama. In addition, the swabbing technique was done on the wooden beehive of the kelulut to evaluate the environmental contamination. The pathogenic bacteria were isolated using specifically selected agar, such as Bacillus cereus agar (for B. cereus), Baird-Parker agar (for Staphylococcus aureus), and MacConkey agar (for other pathogenic bacteria), which were confirmed through a biochemical test. All samples were analysed, and the results showed that B. cereus (7/48), Pseudomonas aeruginosa (10/48), Pantoea spp. (11/48), Serratia plymuthica (6/48), and S. aureus (9/48) were obtained in the samples. This study indicates that kelulut honey was contaminated with B. cereus, P. aeruginosa, Pantoea spp., S. plymuthica, and S. aureus. Isolated pathogenic bacteria may exist in the kelulut honey through food handlers, utensils, and the environment. Hence, the stakeholders should strictly follow good standard operating procedures and guidelines by the kelulut honey industry to prevent foodborne illness.

Factors associated with the author-reported cost-effectiveness threshold in high-income countries: systematic review and multivariable modelling.

The cost-effectiveness threshold (CET) is a key parameter to guide objective reimbursement decisions, yet very few countries have defined a reference CET, and there is no reference method for defining it. Our objective was to determine the factors explaining the author-reported CETs in the literature. Our systematic review targeted original articles referenced in EMBASE and published between 2010 and 2021. Selected studies had to use Quality-Adjusted Life-Year (QALY), and being conducted in high-income countries. Our explanatory variables were: estimated cost-effectiveness ratio (ICER), region of the world, source of funding, type of intervention, disease, year of publication, justification of the author-reported Cost-Effectiveness Threshold (ar-CET), economic perspective, and declaration of interest. Multivariable linear regression models implemented on R software were used, guided by a Directed Acyclic Graph. Two hundred and fifty four studies were included. The mean ar-CET was €63,338/QALY (standard deviation (SD) 34,965) overall, and €37,748/QALY (SD 20,750) in studies conducted in the British Commonwealth. The ar-CET increased slightly with the ICER (+ 66€/QALY for each additional 10,000€/QALY in the ICER, 95% confidence interval (IC) [31-102], p < 0.001), was higher in the United States (+ 36,225€/QALY; IC [25,582; 46,869]) and Europe (+ 10,352€/QALY; IC [72; 20,631]) compared to the British Commonwealth (p < 0.001), and was higher when the ar-CET was not defined a priori (+ 22,393€/QALY; [5809; 38,876]) compared to state recommendations defined ar-CET (p < 0.001). Our results underline the virtuous role of state recommendations in the choice of a low and homogeneous CET. We also highlight the need to integrate the a priori justification of the CET into good publishing guidelines.

Pendidikan Karakter Siswa dalam Meningkatkan Kesadaran Kebersihan Lingkungan di MIN 3 Aceh Barat

Character education is an effort made by an educator that aims to instill good behavior in students. In an effort to increase awareness of environmental cleanliness MIN 3West Aceh adopts a policy to implement character education that is aware of environmental cleanliness for students. This study aims to determine student character education in increasing awareness of environmental cleanliness at MIN 3 West Aceh. This study used a qualitative approach with data collection techniques using observation, interviews, and documentation, while data analysis techniques used descriptive methods with an inductive approach. The results of this study indicate that student character education in increasing awareness of environmental cleanliness at MIN 3 West Aceh includes (1) the existence of a self-development program including daily routine activities, spontaneous, exemplary, and school conditioning. (2) There are supporting and inhibiting factors for character education that are aware of environmental cleanliness in West Aceh MIN 3. The supporting factors include teachers, infrastructure, the role of parents and cooperation between the head of the madrasa, teachers and students. While the inhibiting factor is the unavailability of two types of segregated trash bins and the character of the students. (3) The strategies used in this research include carrying out routine activities, the cleanliness ambassador program, following good guidelines and monitoring and advising students when they make mistakes such as littering.