Implementation Of Management Strategies Research Articles

PENGARUH MANAJEMEN TALENTA DAN MOTIVASI KERJA TERHADAP KINERJA PEGAWAI KANTOR CAMAT TEMBILAHAN HULU KABUPATEN INDRAGIRI HILIR

This research aims to examine the influence of talent management and work motivation on employee performance at the Tembilahan Hulu Subdistrict Office, Indragiri Hilir Regency. The research results show that talent management has a positive and significant influence on employee performance. Implementation of effective talent management strategies, such as the introduction and development of potential employees and the placement of employees based on their skills and interests, contributes positively to employee performance. Apart from that, work motivation also has a positive and significant influence on employee performance. Intrinsic and extrinsic motivation, such as a sense of accomplishment, responsibility, recognition, and financial incentives, provide additional encouragement for employees to achieve better performance. The practical implication of this research is the importance of developing effective talent management policies and programs and creating a work environment that supports employee motivation. By implementing this strategy, it is hoped that employee performance can be improved, which in turn will have a positive impact on the effectiveness and efficiency of office operations and increase public trust in the services provided.

Belowground C sequestrations response to grazing exclusion in global grasslands: Dynamics and mechanisms

Globally, grazing exclusion is a widely implemented management strategy for restoring degraded grassland ecosystems and sequestering carbon (C). However, there is limited understanding regarding the temporal responses and underlying factors influencing ecosystem C stocks following grazing exclusion. In this study, we conducted a comprehensive synthesis of data from 199 independent experiments (454 pairwise observations) to analyze responses of plant and soil C stocks to grazing exclusion across four distinct grassland ecosystems (desert, typical, meadow, and alpine) in the globe. We found that rates of change in plant biomass C stocks and soil organic C stocks exponentially or rationally decreased with years since enclosure. Grazing exclusion generally enhanced aboveground biomass C in plants, while its effects on C stocks of belowground biomass and soil were more contingent upon various factors, such as climate, initial levels of C stocks, and grazing exclusion duration. Furthermore, the responses of C stocks of plant biomass and soil to livestock grazing cessation tend to stabilize over time, with equilibrium typically reaching after approximately 40 years, while soil C sequestration responses exhibited a lagged pattern compared to plant biomass C. Our results underscored the effectiveness of grazing exclusion as an effective strategy to enhance C stocks in regions characterized by low C content and non-water limited conditions. We propose that grazing exclusion for 1–5 years was the best restoration time for typical, meadow and alpine grasslands. Given the limited effects of grazing exclusion on soil organic C stocks of desert types, grazing exclusion might not be an effective measure to increase the soil organic C stocks in water-limited areas like desert grasslands.

Implementasi Strategi Manajemen Konflik untuk Mencegah Kekerasan di Sekolah

This study aims to provide an understanding of the implementation of conflict management strategies to prevent violence in schools. The research method used is a literature study. The literature study approach requires a number of reading materials to be carried out by managing research materials, taking notes while reading, and gathering information from the library. This study found several things about the correlation between conflict and violence that occurred in the school environment. Conflicts that arise in schools can be reduced and even overcome by using conflict management techniques to the maximum extent possible. In addition, this study discusses effective conflict management in schools which is important for preventing violence. This involves taking proactive and reactive actions to resolve conflicts before they lead to violence. It also involves education and training for students, teachers and staff to resolve conflicts peacefully. Good conflict management can help create a safe and conducive school environment for learning. Therefore, good conflict management in schools is very important to prevent violence and ensure student safety.
 Keywords: Conflict, Conflict Managemen, Violence in Schools

Characteristics and spatial identification of Antillean manatee (Trichechus manatus manatus Sirenia: Trichechidae) strandings in Guatemala

Introduction: Marine mammal strandings can be used to determine the impacts of anthropogenic activity on the species survival, population health, and levels of environmental pollution in ecosystems. In addition, these data can help design conservation and management strategies as well as identify priority areas for the species. The West Indian manatee (Trichechus manatus) is listed as endangered throughout its range. In Guatemala, it is distributed along the Caribbean coast. Anthropogenic activities appear to be having a direct pressure on the species, affecting the status of the population.
 Objective: The general purpose of this study was to analyze the 30 years of documented manatee stranding reports available for Guatemala. Two specific objectives were defined to: 1) conduct a spatial analysis of manatee strandings to identify the areas of high stranding concentration, and 2) determine whether there were sex differences in the number of strandings.
 Methods: Characteristics and areas of concentration of manatee strandings were described along the Caribbean coast between 1992 to 2022. Sites with the highest probable density of strandings were identified using a Kernel density analysis. We compared the number of stranding events that occurred in each protected area that included manatees in their management plans and each municipality of Izabal. We determined whether there were sex differences in the number of stranded manatees. We use the potential biological removal to estimate the maximum number of manatees that can be removed from the population due to anthropogenic causes without negatively impacting species survival.
 Results: Forty-three manatee stranding events were recorded throughout the species’ range in Guatemala (48 total individuals). The sites with the highest predicted density of strandings were Santo Tomás de Castilla bay, followed by Lake Izabal (including the limits of the Refugio de Vida Silvestre Bocas del Polochic) and Parque Nacional Río Dulce. The majority of the cases were registered in protected areas (60 %). Estimates of potential biological removal were equivalent to less than one manatee per year, which was exceeded by the annual average of stranded manatees recorded (three manatees).
 Conclusions: Anthropogenic activities cause mortality of manatees in this region, despite the implementation of protected areas. Poaching was identified as the main cause of manatee mortality in Guatemala. The implementation of management strategies focused on minimizing threats to the species, based on the application of environmental legislation and environmental awareness, is essential. The creation and implementation of a protocol for the stranding of marine mammals on the Caribbean coast of Guatemala is necessary, in order to obtain standardized records of these events and conduct rescue efforts and releases when possible.

Mapeamento de zonas de potencial erosivo em uma bacia hidrográfica Brasileira: rumo a um planejamento territorial sustentável

Soil erosion is one of the greatest environmental problems in the 21st Century, mainly due to the economic, social, and environmental damages caused worldwide. Brazil is inserted within this context, where the implementation of strategies to support territorial planning aimed at soil conservation is urgently required. Thus, this work aimed to use geoenvironmental cartography techniques to map the potential erosive zones at the Gouveia stream watershed (Brotas, Brazil) based on geographic data systematized by geoprocessing. Parameters of geology, pedology, terrain shape, terrain slope, land use, and land cover were used and systematized in a GIS environment through mathematical operations and fuzzy inference to map the potential erosive zones. The results indicate that 63% of the basin consists of “High” and “Very High” potential areas for the erosion process, which requires an urgent need to implement management strategies and sustainable territorial planning. This approach can potentially contribute to the decision-making process in the study area and be applied in other watersheds worldwide.

An ethics framework for social listening and infodemic management

Abstract Issue Successful response to an infodemic requires social listening and integrated analysis to produce infodemic insights by identifying questions, concerns, information voids and circulating narratives including health misinformation. There is currently a wide variation in social listening and infodemic insights generation practices, and a lack of frameworks to be applied on ethical values and standards. Description of the problem In the context of infodemic management, infodemic insights are generated based on social listening, health system and data from online and offline sources. Where there is a difference between health guidance and behaviors during an emergency, rapid infodemic insights can help understand the underlying drivers of this divergence. Integrated analysis of this data informs infodemic management strategies generate insights that advise a wide range of public health interventions. Present ethical challenges influence data processing and use. Results The World Health Organization (WHO) convened a group of experts to develop an ethical framework for social listening and infodemic management. It will guide health authorities and practitioners in planning and setting up infodemic insights teams and implementing infodemic management activities. To support the deliberation of the WHO expert group, a systematic review has been conducted to understand present ethical concerns and challenges. Lessons Infodemic management strategies raise ethical concerns that relate to data control, commercialization, transparency, accountability and implications. Power and power imbalances, human rights, privacy and dignity, trust and respect for cultural practices may arise during data collection, analysis, interpretation, and intervention design. Without proper ethical oversight and guidance, the implementation of infodemic management strategies could harm individuals and communities, erode trust, and undermine the effectiveness of responses to a public health emergency. Key messages • Social listening and infodemic management by health authorities require consideration of ethical principles and guidance. • WHO ethics guidance will help public health authorities establish infodemic management practices, policies and strategies.

Challenges in Coagulation Management in Neurosurgical Diseases: A Scoping Review, Development, and Implementation of Coagulation Management Strategies.

Bleeding and thromboembolic (TE) complications in neurosurgical diseases have a detrimental impact on clinical outcomes. The aim of this study is to provide a scoping review of the available literature and address challenges and knowledge gaps in the management of coagulation disorders in neurosurgical diseases. Additionally, we introduce a novel research project that seeks to reduce coagulation disorder-associated complications in neurosurgical patients. The risk of bleeding after elective craniotomy is about 3%, and higher (14-33%) in other indications, such as trauma and intracranial hemorrhage. In spinal surgery, the incidence of postoperative clinically relevant bleeding is approximately 0.5-1.4%. The risk for TE complications in intracranial pathologies ranges from 3 to 20%, whereas in spinal surgery it is around 7%. These findings highlight a relevant problem in neurosurgical diseases and current guidelines do not adequately address individual circumstances. The multidisciplinary COagulation MAnagement in Neurosurgical Diseases (COMAND) project has been developed to tackle this challenge by devising an individualized coagulation management strategy for patients with neurosurgical diseases. Importantly, this project is designed to ensure that these management strategies can be readily implemented into healthcare practices of different types and with sustainable integration.

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis

BackgroundPostoperative delirium (POD) is a frequent neurologic dysfunction that often leads to more negative outcomes. Early identification of patients who are vulnerable to POD and early implementation of appropriate management strategies could decrease its occurrence and improve patient prognosis. Therefore, this meta-analysis comprehensively and quantitatively summarized the prevalence and related predictive factors of POD in head and neck cancer surgical patients.MethodsPubMed, Embase, and Cochrane Library were searched for observational studies that reported the prevalence and risk factors for POD after head and neck cancer surgery and were published from their inception until December 31, 2022. Two reviewers independently selected qualified articles and extracted data. The qualities of related papers were assessed using the Newcastle-Ottawa scale (NOS). RevMan 5.3 and Stata 15.0 were applied to analysis the data and conduct the meta-analysis.ResultsSixteen observational studies with 3289 inpatients who underwent head and neck cancer surgery were included in this review. The occurrence of POD ranged from 4.2 to 36.9%, with a pooled incidence of 20% (95% CI 15–24%, I2 = 93.2%). The results of this pooled analysis demonstrated that the statistically significant risk factors for POD were increased age (OR: 1.05, 95% CI: 1.03–1.07, P < 0.001), age > 75 years (OR: 6.52, 95% CI: 3.07–13.87, P < 0.001), male sex (OR: 2.29, 95% CI: 1.06–4.97, P = 0.04), higher American Society of Anesthesiologists grade (OR: 2.19, 95% CI: 1.44–3.33, P < 0.001), diabetes mellitus (OR: 2.73, 95% CI: 1.24–6.01, P = 0.01), and history of smoking (OR: 2.74, 95% CI: 1.13–6.65, P = 0.03).ConclusionsPOD frequently occurs after head and neck cancer surgery. Several independent predictors for POD were identified, which might contribute to identifying patients at high risk for POD and play a prominent role in preventing POD in patients following head and neck cancer surgery.

Fuel Type Mapping Using a CNN-Based Remote Sensing Approach: A Case Study in Sardinia

Accurate fuel mapping is crucial for effectively determining wildfire risk and implementing management strategies. The primary challenge in fuel type mapping lies in the need to develop accurate and efficient methods for identifying and categorizing the various combustible materials present in an area, often on a large scale. In response to this need, this paper presents a comprehensive approach that combines remote sensing data and Convolutional Neural Network (CNN) to discriminate between fire behavior fuel models. In particular, a CNN-based classification approach that leverages Sentinel-2 imagery is exploited to accurately classify fuel types into seven preliminary main classes (broadleaf, conifers, shrubs, grass, bare soil, urban areas, and water bodies). To further refine the fuel mapping results, subclasses were generated from the seven principles by using biomass and bioclimatic maps. These additional maps provide complementary information about vegetation density and climatic conditions, respectively. By incorporating this information, we align our fuel type classification with the widely used Standard Scott and Burgan (2005) fuel classification system. The results are highly promising, showcasing excellent CNN training performance with all three metrics—accuracy, recall, and F1 score—achieving an impressive 0.99%. Notably, the network exhibits exceptional accuracy in a test case conducted in the southern region of Sardinia, successfully identifying Burnable classes in previously unseen pixels: broadleaf at 0.99%, conifer at 0.79%, shrub at 0.76%, and grass at 0.84%. The proposed approach presents a valuable tool for enhancing fire management, contributing to more effective wildfire prevention and mitigation efforts. Thus, this tool could be leveraged by fire management agencies, policymakers, and researchers to improve the determination of wildfire risk and management.

On the conservation of white-clawed crayfish in the Iberian Peninsula: Unraveling its genetic diversity and structure, and origin.

European crayfish species are a clear example of the drastic decline that freshwater species are experiencing. In particular, the native species of the Iberian Peninsula, the white clawed-crayfish (WCC) Austropotamobius pallipes, is listed as "endangered" by the IUCN and included in Annex II of the EU Habitat Directive and requires especially attention. Currently, implemented conservation management strategies require a better understanding of the genetic diversity and phylogeographic patterns, as well as of its evolutionary history. For this purpose, we have generated the largest datasets of two informative ribosomal mitochondrial DNA regions, i.e., cytochrome oxidase subunit I and 16S, from selected populations of the WCC covering its geographical distribution. These datasets allowed us to analyze in detail the (i) genetic diversity and structure of WCC populations, and (ii) divergence times for Iberian populations by testing three evolutionary scenarios with different mtDNA substitution rates (low, intermediate, and high rates). The results indicate high levels of haplotype diversity and a complex geographical structure for WCC in the Iberian Peninsula. The diversity found includes new unique haplotypes from the Iberian Peninsula and reveals that most of the WCC genetic variability is concentrated in the northern and central-eastern regions. Despite the fact that molecular dating analyses provided divergence times that were not statistically supported, the proposed scenarios were congruent with previous studies, which related the origin of these populations with paleogeographic events during the Pleistocene, which suggests an Iberian origin for these WCC. All results generated in this study, indicate that the alternative hypothesis of an introduced origin of the Iberian WCC is highly improbable. The result of this study, therefore, has allowed us to better understand of the genetic diversity, structure patterns, and evolutionary history of the WCC in the Iberian Peninsula, which is crucial for the management and conservation needs of this endangered species.

Plastic pollution in a coral reef climate refuge: Occurrence of anthropogenic debris, microplastics, and plasticizers in the Gulf of Aqaba

The Gulf of Aqaba in the northern Red Sea, considered a coral reef refuge from the negative effects of climate change, is however being subjected to increasing amounts of plastic contamination. We quantified the levels of benthic plastic debris, microplastics, and plasticizers within the coral reef's surrounding seawater and sediment over time. Our results indicate that the coral reefs of the GoA have relatively lower levels of plastic pollution compared to reefs in other regions. The measured benthic debris in the Red Sea reefs was found to be 0.093 ± 0.091 item/m2 and fell within the reported levels found in other tropical coral reefs, with boating and fishing materials being the most abundant type. Deep mesophotic reefs were found to have significantly higher levels of benthic plastic debris compared to the shallower reefs. Microplastic levels in the surrounding seawater of the reef were 0.516 ± 0.317 microplastics/m3. These concentrations in the reef's surrounding waters are comparable to the levels observed in surface waters from the central Red Sea. The target plasticizers appeared infrequently in samples, and the concentrations for the majority of them were below the level of quantification (LOQ = 14.7 ng/l for water and 14.7 ng/g for sediment). The findings from this study provide a valuable scientific basis for shaping regional policies and implementing management strategies aimed at controlling and mitigating plastic pollution. Such policies can ensure the long-term protection of the reefs in the northern Red Sea, turning them into a secure coral refuge shielded from both global and local anthropogenic stressors.

Analysis of Socioeconomics and Occupational Dimensions of Shrimp Farmers of Tamil Nadu

Studies on socioeconomic, communication media usage, occupational, and sociopsychological attributes of farmers are prerequisite for planning, designing, and successful implementation of sustainable management strategies of a sector which is true for Penaeus vannamei shrimp farming also. The state of Andhra Pradesh in India ranks first in shrimp farming. However, Tamil Nadu state has a lot of potential and is slowly catching with third position, so the baseline profile of shrimp farmers of Tamil Nadu was collected through interviews with 316 shrimp farmers in Nagapattinam, Mayiladuthurai, Thanjavur, and Thiruvallur districts. Most shrimp farmers were men of middle-age, with experience ranging from 1 to 5 years with secondary school to graduate level education. About 89.36% of shrimp farmers had taken loans for the purpose of shrimp farming whereas 78.16% were depending on income from shrimp farming as a repayment source. The benefit–cost ratio of shrimp farming was 2.2 indicating profitability so 79.37% of them were able to save money. However, for 86.53% this was a major expenditure too indicating its vital role in their life. For acquiring information for shrimp farming, 40% relied on friends and 24% relied on fellow farmers. Shrimp farmers were well-versed with the present-era mass-media and through smartphones they acquired information from apps like YouTube. Innovation proneness, scientific orientation, and economic motivation were found to be high in about 30% of farmers. Proper planning is essential for sustainable shrimp farming and sustaining the socioeconomic benefits. The studied attributes play an important role in formulation, designing, and successful implementation of sustainable shrimp farming.

Differential responses of crop yields to multi-timescale drought in mainland China: Spatiotemporal patterns and climate drivers

Increasingly frequent and severe droughts pose a growing threat to food security in China. However, our understanding of how different crops respond to multi-timescale drought under varying climatic conditions remains limited, hindering effective drought risk management. To address this knowledge gap, we applied spatial principal component analysis (SPCA) to unveil spatiotemporal patterns in annual yields of major grain crops (rice, wheat, maize) and cotton in response to multi-timescale drought, as indicated by the standardized precipitation evapotranspiration index (SPEI) across China. Subsequently, predictive discriminant analysis (PDA) was employed to identify the primary climatic factors driving these response patterns. The findings indicated that drought-induced interannual variability of crop yields were spatially and temporally heterogeneous, closely tied to the timescale used for drought assessment. Crop types displayed distinct responses to drought, evident in the variations of months and corresponding timescales for their strongest reactions. The initial three principal components, capturing over 65 % of drought-related yield variance, unveiled short- to medium-term patterns for rice, maize, and cotton, and long-term patterns for wheat. Specifically, rice was highly susceptible to drought on a 4-month timescale in September, wheat on a 6-month timescale in May, maize on a 3-month timescale in August, and cotton on a 3-month timescale in September. Moreover, the first three discriminant functions explaining over 90 % of the total variance, effectively distinguish spatiotemporal crop yield response patterns to drought. These patterns primarily stem from seasonal climatic averages, with water balance (precipitation minus potential evapotranspiration) and temperature being the most influential variables (p < 0.05). Interestingly, we observed a weak correlation between drought severity and crop yield in humid conditions, with responses tending to manifest over longer timescales. These findings enhance our comprehension of how drought timescales impact crop yields in China, providing valuable insights for the implementation of rational irrigation management strategies.

Reliability and Validity of the Spanish Adaptation of the Stanford Proxy Test for Delirium in Two Clinical Spanish-Speaking Communities

Delirium is the most prevalent neuropsychiatric syndrome experienced by patients admitted to inpatient clinical units, occurring in at least 20% of medically hospitalized patients and up to 85% of those admitted to critical care units. Although current guidelines recommend the implementation of universal prevention strategies, the use of management strategies largely depends on constant surveillance and screening. This allows for the timely diagnosis and correction of its underlying causes and implementation of management strategies. It was to adapt and analyze the Spanish adaptation of the Stanford Proxy Test for Delirium (S-PTDsv) instrument for its use among Spanish-speaking populations. The S-PTD is an instrument consisting of 13 observational items to be completed by a clinician observer, usually the patient's nurse. The completion of the questionnaire takes about 1 minute and does not require the active participation of the person evaluated, which has important clinical advantages compared to other available instruments (e.g., the Confusion Assessment Method). The psychometric properties of the S-PTDsv were evaluated in a population of 123 patients using a quantitative, cross-sectional design. All subjects were over 18 years of age and hospitalized in various inpatient medico-surgical and intensive care unit services, either at the Barcelona Clinical Hospital (Barcelona, Spain) or the UC-Christus Health Network Clinical Hospital (Santiago, Chile, S.A.). The ultimate diagnosis of delirium was made by a member of the Psychiatry Consult Service by means of an independent neuropsychiatric evaluation based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, published in 2013, which is the latest version of the diagnostic manual. All study tests were performed by study personnel who were blinded to each other's test results within an hour of each other. In the receiver operator characteristic (ROC) curve analysis, the S-PTDsv demonstrated excellent classification qualities when compared with the DSM-5 as the classification reference standard. Using a cutoff point of ≥3, the S-PTDsv had a sensitivity of 94% and a specificity of 97%. The area under the curve indicator was equal to 0.95, suggesting the S-PTDsv has an excellent overall performance in accurately identifying cases of delirium. Accordingly, the S-PTDsv's positive predictive value=0.93, and the negative predictive value=0.97. The internal reliability measured with Cronbach's alpha was 0.96. Confirmatory factor analysis revealed a 1-dimensional structure with high loadings (>0.72), demonstrating that all items similarly contribute to the total diagnostic dimension, suggesting adequate construct validity. This provided evidence of convergent validity. The performance of the S-PTDsv, as compared to a blinded neuropsychiatric assessment based on DSM-5, indicates that it is an effective instrument for the detection of delirium, in the Spanish-speaking populations. These results are comparable and consistent with previously published studies in the English language version.

Maintaining understory vegetation in oil palm plantations supports higher assassin bug numbers

Abstract The expansion of oil palm agriculture across Southeast Asia has caused significant biodiversity losses, with the reduction in habitat heterogeneity that accompanies the conversion of forest to oil palm being a major contributing factor. However, owing to their long commercial lifespan, oil palm plantations can support relatively high levels of vegetation complexity compared to annual crops. There is therefore potential for the implementation of management strategies to increase vegetation complexity and associated within‐plantation habitat heterogeneity, enhancing species richness and associated ecosystem functioning within productive oil palm landscapes. This study focusses on two species of asassin bugs Cosmolestes picticeps and Sycanus dichotomus, which are important agents of pest control within oil palm systems. Using a Before‐After Control‐Impact experimental manipulation in Sumatra, Indonesia, we tested the effect of three alternative herbicide spraying regimes and associated vegetation complexity treatments on assassin bug numbers. Our treatments encompass a range of current understory vegetation management practices used in oil palm plantations and include removing vegetation only in areas key to harvesting (“Normal”), removing all understory vegetation (“Reduced”), and allowing native vegetation to regrow naturally (“Enhanced”). We assessed both the long‐term (18 months) and short‐term (within 2 weeks) effects of our treatments following herbicide spraying. Pre‐treatment, we found high numbers of assassin bugs of both species in all plots. Long‐term post‐treatment, the abundance of both C. picticeps and S. dichotomus declined in reduced understory plots, although this decline was only significant for C. picticeps (98%). In contrast, there were no significant differences in the post‐treatment abundance of either species in the short‐term. These results suggest that the long‐term decline in assassin bug abundance was likely to be caused by loss of vegetation, rather than any immediate effects of the herbicide spraying. Our findings have clear management implications as they demonstrate that maintaining vegetation in oil palm understories can benefit an important pest control agent.

The new Marine Stewardship Council requirements to improve ghost gear management: Insights from the policy development process

Abandoned, lost or discarded fishing gear, otherwise known as ‘ghost gear’, impacts marine ecosystems in a variety of important ways. The growing recognition of these impacts has led to an evolution of fisheries management with a focus on gear loss avoidance and ghost gear mitigation. The Marine Stewardship Council has responded to the global ghost gear challenge through important revisions made to its Fisheries Standard during the recent Fisheries Standard Review (FSR). Fisheries certified against the Fisheries Standard will now be required to explicitly assess and manage their ghost gear impact on target stocks, on bycatch and on marine habitats - this outcome received strong support during public consultation undertaken for the policy development process. These changes are aimed implementation of best practice management strategies which emphasise gear loss preventative measures supplemented by mitigation and remedial action to minimise impact of ghost gear. The paper covers key insights of the policy development process which supported these changes including best practice research, policy design, public consultation, and impact testing. Conclusions of the policy process are discussed, included their likely implications for fisheries currently certified and those planning to seek certification against the MSC Fisheries Standard.

The Effect of Neuropathic Pain on Psychological Well-Being of An Individual

This comprehensive study delves into the intricate relationship between neuropathic pain and psychological well-being among individuals while exploring the multifaceted influences of pain severity, gender, socio-economic class, and potential gender-based disparities. Employing a cross-sectional design, data were meticulously gathered from a sample of 110 participants within a medical facility. To assess neuropathic pain and psychological well-being, the study thoughtfully employed self-report measures, notably the DN4 Questionnaire for pain assessment and the Satisfaction with Life Scale for evaluating psychological well-being. The findings of this study unveiled a robust and statistically significant negative correlation between neuropathic pain and psychological well-being (r = -0.87, p = 0.02). This compelling correlation indicates that as the severity of neuropathic pain escalates, psychological well-being tends to markedly diminish. This relationship was further corroborated through linear regression analysis, demonstrating that for each incremental unit increase in neuropathic pain, there is a corresponding decrease of 0.87 units in psychological well-being (p = 0.001). Furthermore, this study unearthed noteworthy negative correlations between neuropathic pain and distinct domains of life, encompassing general activity, mood, normal work, relationships, sleep and enjoyment in life. These correlations illuminate that as the severity of neuropathic pain intensifies, individuals encounter impediments in various facets of their lives, including their daily activities, emotional states, work performance, social interactions, sleep quality, and overall life satisfaction. Notably, the socio-economic class emerged as a salient factor influencing well-being, with individuals in the middle class exhibiting significantly higher well-being scores when compared to their counterparts in the lower socioeconomic class (F = 5.770, p = 0.004). Intriguingly, gender did not wield a substantial impact on either well-being or pain levels in this study's context. The profound implications of these findings underscore the imperative necessity for the development and implementation of comprehensive pain management strategies, as well as robust psychosocial support systems tailored to individuals grappling with neuropathic pain. Future avenues of research should consider adopting longitudinal study designs to gain insights into the evolution of these relationships over time and should also explore nuanced cultural and gender-related factors that might further elucidate the complex interplay between pain experiences and psychological well-being.

Level of implementation of pain management and early mobilization strategies to prevent delirium in geriatric trauma patients: A mixed-methods study

BackgroundPain management and early mobilization strategies are recommended in clinical practice guidelines for the prevention of delirium in older adults. However, available data on the implementation of these strategies in trauma are limited. AimsTo describe the use of pain management and early mobilization strategies in older adults at a level I trauma center, as well as the facilitators and barriers to their implementation. MethodsA convergent mixed methods study was used. Quantitative data were collected from sixty medical records. Qualitative data was collected through a focus group with healthcare providers to explore their perspectives regarding the use of the target practices and on barriers and facilitators to their implementation. Descriptive statistics were calculated, and a thematic analysis using an inductive and deductive interpretative descriptive approach was undertaken. ResultsA question on the presence/absence of pain was the most frequently documented pain assessment method. Pain assessment was poorly documented. Frequencies of non-opioid and opioid administrations were similar, but non-pharmacological strategies were not widely used. The first mobilization was performed quickly and was most commonly to a chair. The focus group discussion confirmed many of the data collected in the medical records. Barriers to implementing the targeted strategies were primarily related to organizational context and facilitation processes. ConclusionsAreas for improvement were identified including pain assessment, the use of non-pharmacological pain management strategies and ambulation as a mobilization strategy. Our findings will serve as a starting point for optimizing and adapting practices for geriatric trauma patients and evaluating their impact.

Dosimetric Impact of Intrafraction Prostate Motion and Interfraction Anatomical Changes in Dose-Escalated Linac-Based SBRT

The aim of this study was to investigate the impact of intrafraction prostate motion and interfraction anatomical changes on dose metrics and the effect of beam gating and motion correction in dose-escalated Linac-based SBRT. Thirteen patients (56 fractions) with organ-confined prostate cancer underwent dose-escalated FFF-VMAT SBRT. Accurate patient setup was ensured by CBCT, and real-time 3D prostate motion data were obtained using a novel electromagnetic tracking device. Treatment was interrupted when the signals exceeded a 2 mm threshold in any of the three spatial directions and couch position was corrected unless the offset was transient. Prostate trajectories with and without beam gating and motion correction events were reconstructed and analyzed. Rectum and bladder volumes on each daily CBCT were recorded and compared with volumes at simulation. The prostate motion observed for each fraction was incorporated into the patient original treatment plan with an isocenter shift method. Actually, delivered treatments were then obtained by recalculating the reconstructed motion-encoded plan on deformed CTs reflecting the patient CBCT-anatomy of the day. Non-gated treatments were also simulated using the prostate motion data assuming that no treatment interruptions have occurred. Treatment interruptions because of target motion trespassing the predefined threshold occurred in 25 fractions (45%). Rectum and bladder volume changes were relevant in most patients. The mean relative dose differences between actually delivered and planned treatments were -3.0% [-18.5 - 2.8] for CTV D99% and -2.6% [-17.8 - 1.0] for PTV D95% over all 56 fractions. However, the median cumulative CTV coverage with 93% of the prescribed dose turned out to be satisfactory. Urethra sparing was slightly degraded and a mean reduction of rectum and bladder dose was seen in all but two dose metrics: the maximum dose to rectum mucosa and the bladder D40%. Nevertheless, only 2 major deviations in rectum mucosa D0.035cc were observed at the end of the treatment. The greatest contribution to target missing and OARs doses came from the interfraction anatomical variations, while intrafraction prostate motion marginally contributed in gated treatments. In non-gated treatments, further deteriorations by 2.4 - 2.8% in minimum target coverage metrics and by 3.1 - 11.6% in bladder dose parameters would have occurred on average. The implemented motion management strategy and the strict patient preparation regimen, along with current PTV margins, robustness of original treatment plans, and fast FFF beam delivery, ensured no significant degradations of dose metrics due to both intrafraction motion and interfraction anatomical changes. Non-gated treatments would have more widely deteriorated the dosimetry of some individual fractions. Thus, continuous monitoring, beam gating and motion correction are recommended to safely deliver dose-escalated prostate SBRT.

Implementation of Management Strategies to Improve Employee Performance at Rural Banks in East Java

The purpose of this research is to find out the importance of implementing management strategies to improve the performance of employees of Rural Banks in East Java. The limitation of the problem is aimed at decision-making human resources at BPRs in East Java, namely commissioners and directors as information sources. Problem solving is done by interactive analysis which includes data collection, data reduction, data presentation, and verification. In this research, the research team prepared questionnaires for interviewees and the results were used for descriptive analysis of employee performance at PT. Rural Banks in East Java. It can be concluded that the management strategy carried out by BPR management, is the approach of humanism, organizational justice, and spiritual leadership, and Organizational Citizenship Behavior as indicators of the process towards optimizing the performance of BPR human resources. All employees are given opportunities proportionally to develop themselves and are involved in the development of employee human resources which are assets and human capital in the company. In general, BPR governance has implemented the principles of Good Corporate Governance.