Assessment Instrument Research Articles

Identifying gaps in health system governance to eliminate informal patient payments

Abstract Background Informal patient payments continue to exist in many European countries. These payments might take various forms but can be broadly defined as any payments in addition to formal fees determined by the terms of entitlement. Poor health system governance is considered one of the main factors contributing to their presence, although different aspects of governance might be relevant in each country. The aim of this study was to develop an assessment instrument to help identify gaps in health system governance that contribute to informal patient payments. Methods The study has been performed in 2022-2023 in three stages. In the first step, relying on the TAPIC framework and available literature on informal patient payments, we developed a list of questions for each domain of governance: Transparency, Accountability, Participation, Integrity, Capacity. In the second step, the questionnaire was assessed by external experts to ensure it covers the full range of relevant aspects. We then applied the instrument to three European countries, i.e. Denmark, Greece, and Poland, where informal payments differ in scale. Results The developed instrument includes 22 questions in the five TAPIC domains. They particularly refer to the role of governance in eliminating underlying reasons for informal patient payments (poor quality of health care) and effective penalization of these payments. The application of the instrument showed that in two countries where informal payments are more common, i.e. Greece and Poland, quality and waiting time guarantees are poorly defined, monitored, and incentivized, while existing mechanisms only penalize payments proven to be bribes. Conclusions There is a broad range of health system governance aspects that can be directly or indirectly linked to informal patient payments. The proposed instrument can facilitate the development of long- and short-term policies to eliminate informal payments in European countries. Key messages • Policy makers need to take greater account of the role of governance in ensuring health care quality to eliminate informal patient payments. • The lack of mechanisms to penalize all types of informal payments may contribute to the commonness of these payments in Europe.

Depression, posttraumatic stress of migrants and refugees in Germany – a cross -sectional study

Abstract Background Research shows associations between migration status and mental health conditions (e.g., depression). Yet, few representative data on migrants’ health are available. We aim to provide representative data on depression, and posttraumatic stress (PTSD) among migrants in a representative sample in Northwestern Germany. Methods We conducted a longitudinal study with two measurement points using a standardized assessment instrument in a representative sample of 18-65 years olds in Germany. Here we report on the baseline data. To assess socio-demographic characteristics (gender, age, marital status employment status, household income and migration status) we developed a standardized instrument. To assess depression, we used the Patient Health Questionnaire (PHQ-9), to assess PTSD we used the Harvard Trauma Questionnaire (HTQ-5). To investigate associations of migrant status with depression, and PTSD we estimated linear regression models. Results The analytical sample for this study includes n = 437 (male: n = 181, female: n = 256) individuals (age: M = 44.48, range: 18-65). In the total sample 15.1% (n = 66) showed symptoms of depression, and 6.5% showed PTSD (n = 26). Depression was more frequent in migrants than in non-migrants (22.1% vs. 13.4%, p = 0.043; 66.7). Crude linear regression models showed statistically significant associations between migration status and depression (B = 1.998, 95% CI: 0.831; 3.165, p < 0.001), and PTSD (B = 0.204, 95% CI: 0.085; 0.333, p = 0.002). However, models adjusted for gender, age, marital status employment status, household income and migration status suggested significant associations between migration status and PTSD (B = 0.136, 95% CI: 0.009; 0.263, p = 0.036), but not for depression. Conclusions Longitudinal data are needed to better understand trajectories between mental health conditions, PTSD and migration status. Living situation after the migration is of critical importance for mental health of migrants.

A Survey of Dental Hygiene Pre-Clinic Instrumentation Selection and Sequence.

The purpose of this study was to assess the selection and sequence of dental hygiene instruments taught during dental hygiene pre-clinical education in the United States. Exempt status was received from the University of New Mexico's IRB (ID 21-336). A survey was developed with questions to be answered involving decisions for clinical teaching and sequencing on various assessment and implementation instruments during pre-clinic education. The instrument was 11 questions with multiple choice, ranking and short answer. A survey link was included through email invitation and successfully sent to 301 accredited dental hygiene programme directors in the United States. Results were collected and analysed through descriptive statistics. Forty-three of the invited participants completed the survey, a 14% response rate. Almost half (n = 24) of the participants chose to teach the periodontal probe first and 19 chose the explorer. Twenty-five participants selected they teach the sickle scalers first, 14 teach the universal curette scalers first and 4 teach the Gracey curette scalers first. All participants teach electronically powered scalers with 33 teaching after hand instrumentation and 8 before. Results from this study emphasise that educators teach clinical instrumentation from professional opinion, but no attestation specifically suggests the use of evidence-based pedagogical standards for clinical teaching. Dental hygiene programmes could benefit from further research on pre-clinic instrument selection and sequencing as a way of standardised clinical teaching. These clinical implications could advance the science for standardised teaching of clinical instrumentation and sequencing in dental hygiene education.

Development of Diagnostic, Formative and Summative Assessment Instruments in the PjBL Model to Stimulate Students' Critical and Creative Thinking Skills

It is hoped that current education can produce human resources who have strong critical and creative thinking abilities. Students must have critical and creative thinking skills to be able to solve problems efficiently and effectively. The benchmark for determining student success in learning is through evaluation which includes measurements and assessments. The aim of this research is to develop diagnostic, formative and summative assessment instruments in the PjBL model to stimulate critical and creative thinking skills. This type of research is research & development using the ADDIE model. The results of this research obtained the validity of the assessment instrument in the project based learning model with a valid category. The level of practicality of the assessment instrument was categorized as practical by teachers and students. The results of the effectiveness of the knowledge aspect with the results of the pretest and posttest are seen from the classical completeness of each skill which has reached a level of completeness above the minimum expected score. The N-Gain value shows results that meet the high criteria.

Authentic Assessment Instrument on Redox Reactions to Assess Students’ Cognitive Skills

Authentic assessment is an assessment approach that enable students to demonstrate in-depth understanding and solve complex problem using systematic thinking skills, but teachers find it difficult to develop due to limited knowledge and time. The aim of this research is to produce an authentic assessment instrument for redox reaction materials; determine the characteristics, quality, and feasibility. The instrument development model used was a combination of Oriondo & Dallo-Antonio with Cohen Swerdlik. The development stages were assessment planning, instrument construction, and product testing. The research subjects were 155 of 10th-grade students from three public high schools in Bukittinggi, selected using random sampling technique. Data collection techniques were tests and non-test, the instruments were open ended questions and validation sheets. The authentic assessment instrument developed criteria are: (1) can assess students’ higher order thinking skills; (2) integrate knowledge with skills and various scientific disciplines; (3) develop 21st century competencies; and (4) involve real or everyday life contexts for cognitive aspect. The trial results were analyzed using the PCM 1-PL approach at IRT using Winstep and Parscale program. The characteristics of the item were stated fit because it met the acceptance requirements for MNSQ, ZSTD, and PT-Measure Correlation and the difficulty is in a relatively good level. The reliability of the instrument was classified as good, with test reliability of 0.72 and item reliability of 0.96.

Learning how to explore spiritual aspects in encounters with patients with chronic pain: a pre-test post-test trial on the effectiveness of a web-based learning intervention

BackgroundIntegrating spiritual aspects into treatment plans can release essential resources for coping with chronic pain. However, some spiritual aspects may also induce distress and hinder the coping process. There is a lack of evidence regarding how to perform the clinical tasks of exploring spiritual aspects and of instruments assessing related competencies. Therefore, we developed a web-based learning module to provide education on the subject alongside corresponding assessment instruments. The module presents the InSpiRe (Integration of Spirituality and/or Religion in patient encounters) protocol. The instruments encompass cognitive, affective, and behavioral dimensions.MethodsThis paper aims to determine (i) the learning effects associated with completing the web-based spiritual-care learning module and (ii) the reliability and validity of the instruments employed. To address these aims, we conducted a pre-test/post-test trial with N = 32 randomly selected fourth-year medical students. During the pre-test, we assessed the students’ knowledge, attitudes, and self-efficacy regarding exploring spiritual aspects. For this purpose, we developed a short-answer knowledge test, an attitude questionnaire, and a self-efficacy scale. Additionally, the students explored spiritual aspects with a simulated patient portraying a person with chronic pain. Three trained raters evaluated the students’ performances using a self-developed scale. In the intervention phase, the students completed the 45-minute learning module on a personal computer. The module presented InSpiRe-related content as text and step-by-step video demonstrations, including hints that denote critical actions. The subsequent post-test was identical to the pre-test.ResultsThe internal consistency was suitable for all respective instruments, and there was an indication of solid validity of the performance test. After completing the spiritual care learning module, the students showed statistically significant increases in knowledge scores and significant positive shifts in their attitudes and levels of self-efficacy regarding exploring spiritual aspects. They also attained significantly higher performance scores in the same regard.ConclusionsCompleting the spiritual-care module is associated with meaningful learning effects on cognitive, affective, and behavioral dimensions related to exploring spiritual aspects, as demonstrated in the post-test conducted shortly after the intervention. Due to good reliability and validity scores, the self-developed instruments can be applied appropriately.

Development of Diagnostic, Formative and Summative Assessment Instruments in the PjBL Model to Strengthen the Profile of Pancasila Physics Students

This research has two purposes. The first is to develop a diagnostic, formative and summative assessment tool using the Project Based Learning (PjBL) model to strengthen the profile of Pancasila physics students. The second is to examine the validity and usability of the developed assessment tool. The first objective outcome is the product of assessment tools in the form of activity and assessment sheets. The outcome of the second objective is to obtain a valid and practical assessment tool that strengthens the student profile of Pancasila. The conclusion from the development of this tool is that the tool developed in the form of activity and assessment pages is practical and suitable for use in the classroom to strengthen the profile of Pancasila physics students.

The “Emorality” of Caring: Validation of an Empirical Model of the Moral Feelings of Affective Care in Teaching Communities

This article presents a study that addresses the challenge of establishing a relationship between the axiological and the affective, by validating a structural model through an assessment instrument (SEMORCUNA) that isolates the moral feelings associated with ‘affective care’. The research sample consisted of 222 teachers, all of whom were either in training or were active professionals in the teaching field. To achieve the research objectives, a group of experts selected a total of 11 moral sentiments, based on which Principal Component Analysis was conducted. Subsequently, Cronbach’s alpha was calculated to determine the internal consistency of the factors obtained. Confirmatory factor analysis was also performed. The results indicate that the selected feelings are part of a single factor. We conclude that all the emotional–moral experiences included in the test are empirically associated with the value of affective care. This work provides a tool to study the degree of teacher identification with the moral feelings that characterize the school as a ‘learning caring institution’, which is a fundamental condition for ensuring ‘resilient educational communities’.

Association Between Dietary Diversity and Subjective Cognitive Decline in the Middle-Aged and Elderly Chinese Population: A Cross-Sectional Study

Background: This cross-sectional study aimed to examine the association between dietary diversity and risk of subjective cognitive decline (SCD), a precursor of dementia, in middle-aged and elderly Chinese populations residing in eastern China. Methods: Participants aged ≥ 45 years were recruited from a community in an eastern Chinese city after excluding potential objective cognitive impairment using the Mini-Cognitive Assessment Instrument (Mini-Cog). SCD was assessed using the Subjective Cognitive Decline Questionnaire-9 (SCD-Q9). Dietary data were collected using the Dietary Quality Questionnaire (DQQ), and the Food Group Diversity Score (FGDS) and the Consumed All Five Recommended Food Score (All-5) were calculated as indicators of dietary diversity. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed to evaluate the associations of FGDS and All-5 scores with SCD after adjusting for age, sex, socioeconomic status, lifestyle factors, and health status. Results: Among the 871 participants, 358 (41.1%) were classified as having SCD. Compared with participants with the highest FGDS (≥8) and those with the highest All-5 score (5), those with the lowest FGDS (≤4) and the lowest All-5 score (≤3) exhibited 85% (OR = 1.85; 95% CI: 1.10–3.13; p = 0.02) and 90% (OR = 1.90; 95% CI: 1.21–2.97; p < 0.01) higher risk of SCD, respectively, after adjusting for all covariates. Fruits were the only food group among the All-5 components that demonstrated a significant association with SCD risk. Conclusions: Poor dietary diversity was associated with an elevated risk of SCD in middle-aged and older adults, and fruits were the food group with the most substantial effect.

Validation of an Actuarial Instrument to Predict Repeat Family Violence for Frontline Police: Calibration, Discrimination and Classification Performance of the VP-SAFvR

Abstract Purpose Police are increasingly tasked with identifying, responding to, and preventing intimate partner and family violence (IPFV). Several police organisations have adopted validated risk assessment instruments to assist frontline police officers to assess and manage the risk of future IPFV. This paper reports a population-based evaluation of the predictive and discriminative validity of an actuarial risk assessment instrument, the Victoria Police Screening Assessment for Family Violence Risk (VP-SAFvR), used by frontline police officers in Victoria, Australia. Methods The entire population (n = 38,454) of family violence reports (FVRs) where police used the VP-SAFvR between 1 September 2019 and 31 March 2020 were tracked for 365 days to ascertain whether the VP-SAFvR was able to predict subsequent family violence and discriminate between cases with and without subsequent family violence. Calibration and survival analysis was performed on the instrument. Results Approximately 33% of the sample was involved in subsequent IPFV over the 12 month outcome period. In line with the development (McEwan et al., 2019) and validation (Spivak et al., 2020) studies of the same instrument, the results show the VP-SAFvR continues to provide adequate consistent discriminative and predictive performance across time. The AUC for repeat IPFV was 0.65, with the recommended threshold score of 4 (or above) identifying 75% of individuals involved in repeat family violence and correctly screening out approximately 50% of non-repeat cases. Conclusions The paper extends the previous research on VP-SAFvR by providing some indication that the tool is well-calibrated. Incidence curves show the largest increase in repeat family violence among those scoring above threshold occurs in the first 90 days post index. The implications and limitations of the study are discussed.

Evaluating Pakistan’s mental healthcare system using World Health Organization’s assessment instrument for mental health system (WHO-AIMS)

BackgroundPakistan faces profound mental health challenges, which necessitate the urgent need for a comprehensive assessment of its mental healthcare system. A holistic understanding of the mental health landscape is essential to identify strengths, weaknesses, and existing gaps within the system, which can inform targeted interventions and policy enhancements to improve mental healthcare accessibility.ObjectiveThe primary objective of this desk research is to conduct an in-depth analysis of Pakistan’s mental healthcare system across various dimensions, guided by the World Health Organization’s Assessment Tool for Mental Health Systems (WHO-AIMS).MethodsData for this desk research and scoping was obtained through desk research, including an examination of existing policies and legislation and consultations with various health facilities across Pakistan. This comprehensive analysis focused on six critical domains within the WHO-AIMS framework: policy and legislation, mental health services, integration of mental health into primary care, public awareness and collaboration with other sectors, human resources, and monitoring and research initiatives.ResultsThe findings provides a snapshot of strength and opportunities for improvement in Pakistan’s mental healthcare system that can serve as the foundation for revising and updating national priorities. Key areas of focus include enhancing policy and legislation, expanding access to mental health services, improving existing initiatives for better integration of mental health into primary care, improving public awareness and sector collaboration, addressing human resource challenges, and strengthening monitoring and research initiatives.ConclusionThis desk research provides a roadmap for refining and enhancing Pakistan’s mental health ecosystem and informs the prioritization of mental health campaigning efforts.

Advancing Digital Education Technologies by Empowering Nurses With Point-of-Care Ultrasound: Protocol for a Mixed Methods Study.

Bedside ultrasonography, also known as point-of-care ultrasound (PoCUS), is a promising technological tool that enhances clinical assessment, enriching diagnostic capabilities and clinical reasoning. Its use in nursing spans various patient populations and health care settings, providing nurses with a valuable health assessment tool to improve care quality and patient safety. Despite its growing integration into clinical practice, PoCUS training has mainly focused on physicians, leaving a gap for trained nurses who demonstrate similar proficiency in conducting scans and interpreting images. Previous research highlights the value of digital tools in PoCUS training, showing their role in improving professionals' and students' knowledge, image interpretation skills, and clinical acumen. This study aimed to (1) establish an assessment instrument gauging nurses' competency milestones in PoCUS and evaluate its content and appearance validity, (2) develop a series of 5 educational videos focused on PoCUS and assess their content and appearance validity, and (3) construct an online learning environment tailored to nurses' PoCUS training needs and evaluate its content and appearance validity. We will conduct a methodological study of technological production guided by Rogers' diffusion of innovations theory. Subproject 1 will design and validate a comprehensive assessment tool for evaluating nurses' competency milestones in PoCUS use. For this purpose, a scoping review will be conducted. The review will be based on JBI Collaboration guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Reviews (PRISMA-ScR) checklist. Subproject 2 involves an evaluation of content and appearance validity for a series of 5 educational videos on PoCUS, designed specifically for nurses about applying peripherally inserted central catheter lines, inserting nasogastric feeding tubes, assessing gastric residual volume, assessing pressure injuries and soft tissue conditions, and assessing muscle mass to monitor patient nutritional status. In subproject 3, a comprehensive online learning environment dedicated to PoCUS training for nurses will be developed and validated. The launch of an online learning environment represents a cornerstone of our dissemination strategy, scheduled to coincide with the inaugural Brazilian PoCUS symposium for nurses, an event organized by the project members. This platform will serve as a pivotal resource for continuous learning and professional development. Subproject 1 will start in the second half of 2024 and is expected to be completed by mid-2025. Subproject 2 is currently ongoing and is expected to be completed in early 2026. Subproject 3 is set to begin in early 2025 and is planned to be completed by 2026. Through these concerted efforts, the project aims to bridge the existing gap in PoCUS training for nurses, thereby fostering their proficiency and enhancing patient care outcomes. PRR1-10.2196/58030.

Acculturation stress and mental health outcomes in a sample of migrant inpatients: Findings from a naturalistic study.

Migrants face numerous risk factors for mental disorders, including stressors and traumatic events during the pre-, peri-, and post-migratory phases. Acculturation stress, a significant post-migratory stressor, can adversely affect mental health during the cultural adaptation process. This study aims to assess the clinical implications of acculturation stress in migrants admitted to a psychiatric intensive care unit, with a focus on identifying predictors of acculturative stress and their impact on clinical outcomes. We conducted a retrospective study of 268 immigrant patients hospitalized between 2004 and 2019 at the psychiatric inpatient unit of the University of Foggia. We collected socio-demographic and clinical data using ad hoc schedules and validated assessment instruments, including the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF), and the Clinical Global Impression (CGI). Diagnoses were based on DSM-IV-TR/DSM-5 criteria. We analyzed associations between demographic and clinical characteristics of patients reporting acculturative stress and those not reporting it, using appropriate statistical methods. The majority of patients were diagnosed with affective (45.1%) or psychotic disorders (31.7%), with 57.1% experiencing their first psychiatric episode. Acculturation stress was reported by 51.9% of patients (N = 139), predominantly among males (71.9%), single individuals (80.9%), and those of Islamic faith (56.8%). Patients experiencing acculturation stress were more likely to be unemployed (57.6%) and without a residence permit (63.3%). This stress was particularly prevalent among patients with psychotic disorders (25.9%) and first-episode psychiatric cases (64.7%). At discharge, patients with acculturation stress showed less improvement on CGI, GAF, and BPRS scores compared to those without such stress. Acculturation stress is influenced by several socio-demographic factors and is crucial for the full symptomatic remission of migrant patients. Culturally-oriented mental health services, including language and cultural integration programs, are essential in reducing acculturative stress and improving the overall well-being of immigrants.

Measuring evidence-based practice knowledge, skills, attitudes, and behavior in students of manual therapy education programs: A scoping review of instruments and their measurement properties.

The purpose of this review was to identify assessment instruments and their measurement properties for assessing evidence-based practice (EBP) knowledge, skills, attitudes, and behavior among students of manual therapy education programs. 7 electronic databases were systematically searched from inception to May 19, 2023. (MEDLINE, EMBASE, CINAHL, ERIC, EBSCO Discovery, LISA, Google Scholar.) Search terms were subject headings specific to each database (MeSH in MEDLINE) and relevant to evidence-based practice, assessment tools/instruments, and manual therapy healthcare professions. Eligible studies included students of manual therapy education programs (chiropractic, physiotherapy, occupational therapy, osteopathy) and provided evidence supporting instrument measurement properties (reliability, validity). Titles and abstracts were screened by 2 reviewers. Data on each instrument and its properties were extracted and tabulated by 2 reviewers. Instruments were compared using the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework including the 5 steps in the EBP model. Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist were followed. 5 studies were identified, (3 physiotherapy, 2 chiropractic) Two studies used a physiotherapy-focused modification of the Fresno test. One study presented the Knowledge of Research Evidence Competencies instrument. Two studies presented original instruments. Instruments focused on the knowledge domain and did not assess all 5 EBP model steps. The current literature does not address all 5 steps of the EBP model. The identified instruments have the potential to ensure chiropractic institutions are graduating chiropractors who are highly skilled in evidence-based practice.

The impact of work-family conflict on occupational fatigue among endoscopy nurses in China: a moderated mediation model.

Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support. A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0. Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue. There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue.

Application of the Contemporary Psychometrics for Assessing Economic Literacy

Currently, new skills and various types of "new literacies" relevant to the modern world are becoming issues of growing importance. One of them is economic literacy; however, there are only few assessment instruments that fulfil the academic requirements for its assessment among university students. One of such internationally established instruments is the Test of Understanding in College Economics (TUCE), which is a popular tool in empirical studies of economic literacy in many countries around the world. Despite its advantages, the currently available version of the TUCE designed for American colleges back in 2006, is prone to cheating and provides limited opportunities for formative feedback. The purpose of this paper is to present the Updated Test of Understanding in College Economics (U-TUCE). In developing the U-TUCE, we utilized the capabilities of contemporary psychometrics, which offer sufficient advances in overcoming all limitations of the original TUCE mentioned before. First, we present a revised theoretical framework of the U-TUCE, highlighting that the test measures different types of mastery of economic literacy. Second, we describe the approaches used for modifying the TUCE items and developing new items. A half of the original test items have been replaced or redesigned to reflect the economic context that has changed since 2006. Third, we utilize the logic of automatic item generation algorithms to increaseg the level of test protection against cheating. We made all changes in such a way as to maintain comparability with the previous versions of the TUCE test if necessary. Finally, the use of the Item Response Theory (IRT) is paired up with that of Cognitive Diagnostic Modeling (CDM) to ensure the quality of the U-TUCE and enhance its formative value. We show that IRT can be used to estimate the construct as a whole (which is of interest to researchers, administrators, and policy makers), while CDM provides information relating to each of the construct components, which are of interest to educational practitioners and students themselves. The results of the data analyses show that the test can be used for both purposes simultaneously.

Microbiome-based correction for random errors in nutrient profiles derived from self-reported dietary assessments

Since dietary intake is challenging to directly measure in large-scale cohort studies, we often rely on self-reported instruments (e.g., food frequency questionnaires, 24-hour recalls, and diet records) developed in nutritional epidemiology. Those self-reported instruments are prone to measurement errors, which can lead to inaccuracies in the calculation of nutrient profiles. Currently, few computational methods exist to address this problem. In the present study, we introduce a deep-learning approach—Microbiome-based nutrient profile corrector (METRIC), which leverages gut microbial compositions to correct random errors in self-reported dietary assessments using 24-hour recalls or diet records. We demonstrate the excellent performance of METRIC in minimizing the simulated random errors, particularly for nutrients metabolized by gut bacteria in both synthetic and three real-world datasets. Additionally, we find that METRIC can still correct the random errors well even without including gut microbial compositions. Further research is warranted to examine the utility of METRIC to correct actual measurement errors in self-reported dietary assessment instruments.

The effect of corporate governance attributes on human capital disclosure in South Africa

The disclosure of human capital (HC) information in corporate reports continues to be at the centre of discussions in the executive boardroom. Currently, standard setters grapple with implementing uniform disclosure requirements for human capital disclosure (HCD) and as a result this information is scant, erratic, and inconsistently reported. Hence the ISO 30414 was introduced to breach this gap. The aim of the study is to critically examine how corporate governance attributes affect HCD. A quantitative based cross-sectional design was followed using a sample of top 100 companies listed on the Johannesburg Stock Exchange (JSE). The ISO 30414 HR reporting framework containing 48 metrics was utilised to construct an assessment instrument with a 7-point scale to assess the extent of HCD. Overall, board meeting attendance yielded positive statistically significant association with HC information disclosed on recruitment, retention rate, turnover rate, internal mobility rate, competency rate, employee value-added, absenteeism rate. The board of directors play a critical role in improving the disclosure of HC information in the integrated reports. The study provides first empirical evidence on the impact corporate governance attributes have on HCD using the ISO 30414 HR reporting framework.

From childhood to adolescence: the growth of narrative macrostructure in heritage bilingual English speakers

ABSTRACT Narratives are crucial for investigating children’s spontaneous language, offering insights into linguistic changes from early childhood to adolescence. Despite the known improvement in narrative skills with age, research focusing on bilingual children older than 8 is sparse. This study explores narrative macrostructure, episodic complexity, and internal state terms expressing feelings and thoughts among bilingual children in preschool, primary, and secondary school, focusing on English as a heritage language. Narratives were elicited from fifty-nine English-Hebrew bilinguals aged 5–14, divided into three age-groups, using Multilingual Assessment Instrument for Narratives (Gagarina, N., D. Klop, S. Kunnari, K. Tantele, T. Välimaa, I. Balcˇiūnienė, U. Bohnacker, and J. Walters. 2014. “MAIN: Multilingual Assessment Instrument for Narratives.” ZAS Papers in Linguistics 56:1–156), with language exposure data collected from parent questionnaires. Analyses of story grammar elements and episodic complexity revealed significant age-related differences in narrative macrostructure, with older children demonstrating more complex and coherent narratives. The length of exposure to the societal language did not significantly predict narrative outcomes, suggesting that narrative quality is not solely dependent on societal language exposure duration. This study provides valuable baseline data for typical narrative development in bilinguals and could aid in identifying Developmental Language Disorder (DLD) in bilingual populations.

Nursing students' knowledge and related factors towards palliative care: A systematic review

The objective of this systematic review is to assess the extent of nursing students' knowledge concerning palliative care and identify potential factors that may impact it. To carry out their comprehensive and review research, items were searched from the starting point to March 1, 2023, applying keywords gathered from Medical Subject Headings such as "knowledge", "palliative care", and "nursing students" in global online databases involving Scopus, PubMed, Web of Science, and Iranian electronic library including Iranmedex and Scientific Information Database. Using the assessment instrument for cross-sectional studies (AXIS tool), the quality of the studies included in this systematic review was determined. In total, 4,320 nursing students participated in eleven cross-sectional studies. The age mean of the students was 21.48 (standard deviation [SD]=2.32) years. The study comprised 71.43% female participants and 97.92% single. The average nursing student's knowledge of palliative care was 8.94 (SD=3.57) out of 20; the results have shown an insufficient level of knowledge. Factors such as age, female gender, encounter with terminally ill patients, receiving a non-university educational session, year of study, being mature, and receiving a university educational session have a potential positive correlation with nursing students' knowledge of palliative care. Furthermore, the investigation revealed that the following variables had a statistically significant association with nursing students' level of knowledge in palliative care: academic year, perception of death as the cessation of life, receipt of university educational sessions, teaching content related to palliative care, type of university, academic grade, gender, place of birth, monthly family income, religious beliefs, and experience of providing care to a dying family member. The outcomes of this review suggest that nursing students possess inadequate knowledge in the domain of palliative care. Thus, it is recommended that future studies focus on implementing appropriate interventions for nursing students to enhance their level of knowledge regarding palliative care.