Lack Of Communication Skills Research Articles

Enhancing and Explaining Energy Management in Smart Manufacturing Production via ML Within the Context of Industry 4.0

Objective: The aim of this research is to identify the main barriers faced by managers and practitioners in the implementation of KM initiatives in the context of Chilean organisations and to describe the ways in which these problems are addressed by them. Theoretical Framework: This research addresses the organisational, political, social and cultural barriers faced by KM initiatives in developing country contexts. Method: This study was based on the review of twenty-six cases of knowledge management initiatives implemented between 2010 and 2022 in Chile, which were described and analysed using qualitative methodology Results and Discussion: It was found that the most important barriers to carrying out these initiatives coincide, to a large extent, with some of the characteristics of Chilean culture and society described in the literature of organisational studies, such as: lack of trust; large power distance in the organisational structure; lack of communication skills; paternalistic organisational culture, to mention a few. Also, one aspect worth highlighting is the traditional business culture that tends to focus on a "low cost" strategy and exploitation of raw materials, rather than investing in innovation. Scarce resources, problematic performance measurement and lack of knowledge management training for employees and managers were also mentioned as adverse factors. Research Implications: The relevance of this study lies in the fact that it provides insight into the main barriers faced by knowledge management initiatives in developing countries, specifically in a region such as Latin America, thus contributing to the development of this field in this region. Originality/Value: It is known that many of the new initiatives in the field of KM do not thrive or face difficult start-up challenges, limiting the number of successful initiatives in this country. This study contributes to a better understanding of the problems faced by managers carrying out KM initiatives, thus enabling them to develop better strategies and solutions for the implementation of KM projects.

Challenges in teacher-student communication during family medicine residency: A qualitative study.

Deficiencies in communication among healthcare professionals, recognized by medical educators and healthcare institutions, can negatively impact medical education and clinical practice. Analyzing teacher-resident communication difficulties shed light on this issue and propose practical strategies for its mitigation. To identify common communication challenges between teacher and residents during Family Medicine residency and to analyze their impact on interactions with peers, the work team, and patients. Qualitative study, the critical incident technique was used to collect information of interest. Seventy teachers, and fifty third-year residents from the Mexican Republic described critical incidents related to their communication experiences during Family Medicine residency. 192 critical incidents were collected (several participants reported more than one incident), comprising 127 reports from teachers, and 65 from residents. Four themes were identified: 1) asymmetric communication, 2) assertive communication, 3) organizational communication, and 4) effective communication. The main challenges identified were abuse of power in communication, lack of communication skills, and the absence of institutional communication channels. These issues significantly impacted learning, work environment, interpersonal relationships, and medical care. This study highlights communication issues within Family Medicine residency in Mexico. The issues detected hindered learning and effective collaboration and negatively impacted the work environment, interpersonal relationships, and the quality of medical care. These findings underscore the urgent need to reorient the medical specialty curriculum towards an approach that includes communication skills.

Expert consensus on multilevel implementation hypotheses to promote the uptake of youth care guidelines: a Delphi study

BackgroundThe implementation of youth care guidelines remains a complex process. Several evidence–based frameworks aid the identification and specification of implementation determinants and strategies. However, the influence of specific strategies on certain determinants remains unclear. Therefore, we need to clarify which active ingredients of strategies, known as behaviour change techniques (BCTs), elicit behaviour change and improve implementation outcomes. With this knowledge, we are able to formulate evidence–based implementation hypotheses. An implementation hypothesis details how determinants and in turn, implementation outcomes might be influenced by specific implementation strategies and their BCTs. We aimed to identify (1) determinants relevant to the implementation of youth care guidelines and (2) feasible and potentially effective implementation hypotheses.MethodsA four–round online modified Delphi study was conducted. In the first round, experts rated the implementation determinants based on their relevance. Next, experts formulated implementation hypotheses by connecting BCTs and implementation strategies to determinants and were asked to provide a rationale for their choices. In round three, the experts reconsidered and finalised their hypotheses based on an anonymous overview of all formulated hypotheses, including rationales. Finally, the experts rated the implementation hypotheses based on their potential effectiveness and feasibility.ResultsFourteen experts completed the first, second, and third rounds, with 11 completed the final round. Guideline promotion, mandatory education, presence of an implementation leader, poor management support, knowledge regarding guideline use, and a lack of communication skills were reported as most relevant determinants. In total, 46 hypotheses were formulated, ranging from 6 to 9 per determinant. For each determinant, we provide an overview of the implementation hypotheses that were most commonly deemed feasible and potentially effective.ConclusionThis study offers valuable insights into youth care guideline implementation by systematically identifying relevant determinants and formulating hypotheses based on expert input. Determinants related to engagement and to knowledge and skills were found to be relevant to youth care guideline implementation. This study offers a set of hypotheses that could help organisations, policymakers, and professionals guide the implementation process of youth care guidelines to ultimately improve implementation outcomes. The effectiveness of these hypotheses in practice remains to be assessed.

Driver-to-Driver Communication Skills: Contributing Factors to Traffic Accidents on South African Roads?

Road traffic accidents are associated with different factors, such as nonsignalised road networks, inexperienced drivers, a lack of communication skills, distraction, and the visual or cognitive impairment of road users, which have led to this increase in traffic accidents. Understanding these factors in alignment with road user communication skills can provide solutions that can reduce traffic fatalities. Road users’ communication is predominantly formal in nature; informal means of communication also exist but are not given proper attention during the driving training and licence testing processes. Therefore, this study investigated the communication skills between drivers as a factor contributing to traffic accidents in South African cities. Consequently, 16 traffic scenarios of communication between drivers were simulated using PTV Vissim 2022 and Blender 3.0 software, and a semistructured interview questionnaire was used to collect data from South African road users. The questionnaire was further used to evaluate the confidence level of road users concerning informal communication. The data were analysed via regression analysis to establish the relationship between traffic accidents and miscommunication between drivers. The information gathered and analysed from this study helps us to understand the informal communication types between drivers and establish where communication loss exists, which could potentially lead to a traffic accident. The results also show that the misinterpretation of communication signals can present the possibility of a traffic safety risk.

Built environment stakeholders and climate change adaptation: the case of Sri Lanka

PurposeThis study aims to identify key built environment stakeholders in Sri Lanka and to understand their roles and responsibilities in tackling climate change. It also seeks to identify key challenges experienced by stakeholders.Design/methodology/approachSecondary data was systematically reviewed to identify key-built environment stakeholders in Sri Lanka. Thereafter, primary data was collected from a purposively selected sample of 40 built environment experts using a semi-structured interview schedule. The collected data was analyzed using the thematic analysis method.FindingsThe study identified built environment stakeholders in five sectors, namely, the state sector, the private sector, non-governmental organizations, academia and the general public. It was revealed that the state sector is responsible for policy formation and implementation, while the private sector acts as a financial facilitator. Academia generates and disseminates knowledge on climate change and community-based organizations provide inputs. Key skills and knowledge gaps of stakeholders include a lack of comprehension of the climate change theory and its concepts, lack of awareness on policies and legislation, lack of communication skills, language skills, digital proficiency and lack of integrated working skills. Unified action and equitable representation of all stakeholders is necessary to tackle climate change.Originality/valueThe original contribution of the paper is its emphasis on the importance of a multidisciplinary approach to the built environment in relation to climate change adaptations alongside its identification of key knowledge gaps among stakeholders.

Congestion at the Outpatient Department of Lady Ridgeway Hospital Sri Lanka

Lady Ridgeway Hospital for Children is a 125-year-old paediatric hospital with several specialties. There are 1016 beds to accommodate patients. It provides care for children who are less than 14 years old. It is the final referral centre and receives patients from all over the island. It is situated in an easily accessible place. The outpatient department provides consultative service from 07.00 am to 12.00 midnight. It serves 1,500 to 1,800 patients daily and, catered 500 to 600 patients during the COVID-19 pandemic. This case study aims to identify the reasons for congestion at OPD and suggest solutions for them. Observation, key informant interviews, and review of the reports were the data collection methods. Congestion at OPD is due to several factors. Among them, stakeholders identified the need for more guidance for those who attend OPD as the main contributing problem. There were several causes for this problem related to client, staff, environment, process, and information. The OPD is functioning in an old building with other clinics and services. The building is packed with several units. Therefore, the number of clients using these premises is more than those using the OPD service. There needs to be direction boards to guide the patients regarding the available services, even though there are name boards for the rooms. A layout map of the OPD is also not available. The rooms are numbered, not in order. Lack of communication skills, poor attitude, unmotivated staff, inadequate responsiveness, not practicing the satisfaction survey, lack of supportive supervision, and need to have regular training are the other causes. Displaying the direction board and OPD layout will help the clients find their way quickly to reach their destination. In addition, strengthening the staff by providing knowledge and skills, field visits, non-monitory incentives and improving welfare will enhance their communication skills and attitude. Development of the staff will improve the quality of the service. Regular patient satisfaction surveys will help assess the service provision's feedback. The information collected from the survey will help correct the shortcomings and help plan the services in the future. Altogether, these will improve the guidance for the patients who attend the OPD and reduce congestion at OPD. Keywords: Outpatient department, congestion, layout, direction

The Relationship Between Years of Education on Nurse Related Barriers of Patient Education

Background: Patient education is a vital aspect of nursing practice, aimed at improving healthcare outcomes through interactive teaching. Despite its importance, various barriers hinder effective patient education, including time constraints, staff shortages, and organizational challenges. Understanding the factors influencing nurses' attitudes towards patient education is essential, as it directly impacts the quality of care. This study explores the relationship between years of education and nurse-related barriers to patient education, utilizing the PRECEDE model as a framework. Objective: To highlight the relationship between years of education on nurse-related barriers to patient health education. Methods: A descriptive cross-sectional design was used. A study was conducted at the nursing institute of the Peoples University of Medical and Health Sciences, Nawabshah. All bachelor’s science nursing students (Generic) were study subjects. The sample size was 110 student nurses. The questionnaire was developed using the PRECEDE-PROCEED model for health promotion planning and evaluation—data collected and analyzed through the SPSS version 25 software (Statistical Packages for Social Sciences). Results: 100% of the study subjects were female. 84% of students were enrolled in the BSN Generic program. 75% of nurses documented their patient education in their nursing records. The most significant student nurse-related barriers to patient education, were poor knowledge about illness, reluctance to patient education, a lack of perceived responsibility that it is not their responsibility to provide patient education, negative attitude towards patient education, poor or inappropriate knowledge regarding patient education, inadequate attention towards educational, cultural and habitual needs of the patients and their families and lack of communication skills. Conclusion: It is concluded that years of education enhance patient education. Patient education is the prime responsibility of nurses. Since the student years, this practice has perceived the responsibility of nurses and developed a positive attitude towards education.

Identifying Factors Related to Divorce in Iranian Couples: A Case Study in Yazd, Iran

Background: Divorce is one of the most damaging social issues. Since the divorce rates are increasing rapidly, the current study evaluated the effects of factors leading to divorce.
 Methods: In this qualitative study, by using two-stage sampling method (purposive and snowball) 4 couples on the verge of divorce visiting consulting center and 8 experts with experience in the field of family and divorce in Yazd city were selected. Semi-structured interviews were used for data collection. The contents of the interviews were transcribed verbatim and analyzed using a content analysis method.
 Results: The experts who participated in this study included several marriage and divorce registrars, lawyers, and family counselors with over 10 years of experience in the field of family and divorce. The mean age of women on the verge of divorce was 33 ± 8.51 years and for men 37.2 ± 6.13 years. Fifty percent of the couples had a bachelor's degree and 62.5% of them were self-employed. Most of them had a marriage period of 5-10 years. A total of 23 codes were extracted from the interviews. The codes were organized into four main themes. Major topics included lack of preparation for marriage, psychological factors, unfavorable marital relationships, and social factors.
 Conclusion: The interference of families, extramarital relationships, early marriage and the lack of communication skills and media literacy are the most influential factors of divorce.

Optimized Integration of Lean Construction, Building Information Modeling, and Facilities Management in Developing Countries: A Case of Qatar

Over the past decades, the construction industry has benefited from implementing Lean Construction (LC) principles, extensive usage of Building Information Modeling (BIM) tools, and application of advanced Facilities Management (FM) theories as standalone packages. Recently, integrated applications of LC, BIM, and FM have attracted a lot of attention. While progress has been made, few researchers have attempted to develop a method for optimizing integrated applications of LC, BIM, and FM in developing countries. In addition, relatively little is known about the hindrances and challenges in integrating LC, BIM, and FM at various levels of inquiry. The current study contributes to these gaps by examining the challenges that hinder developing countries from adopting integrated applications of LC, BIM, and FM. Qatar, a rapidly developing economy, was used as a case illustration. In the present study, drivers for enabling optimized integration of LC, BIM, and FM were identified. A closed-ended survey was conducted to investigate and understand contextual and organizational factors that hinder the integration of LC, BIM, and FM at three levels of inquiry. Findings displayed that lack of communication skills, language barriers, and inappropriate training provided to low-level skilled workers were the most prominent hindrances. To this end, an integrated communication and collaborative environment for bridging the communication gap was outlined. Furthermore, the wide disparity in the levels of awareness, readiness, and implementation of LC, BIM, and FM across construction companies was identified as a major challenge in deploying and disseminating succinct knowledge on how to optimize the integration of LC, BIM, and FM. To resolve challenges, an integrated collaborative platform for disseminating differentiated knowledge and information on how to seamlessly integrate LC, BIM, and FM was developed. This integrated collaborative platform can be used by authorities to monitor progress and productivity in the construction industry. The significance of this study lies in providing a basis for organizations that intend to implement LC, BIM, and FM in an integrated manner.

COMMUNICATION ANNOYANCE AMONG POLYTECHNIC STUDENTS

Communication Annoyance Among Polytechnic Students Hazariah Karsahid1, Faizatul Absharizan binti Abu Bakar2, Aznurullaili Binti Ahmad Sarkawi3 Jabatan Perdagangan, Politeknik Sultan Azlan Shah Behrang Stesyen, 35950 Behrang, Perak Email : ijasahid73@gmail.com ABSTRACT In the day-to-day process, the ability to communicate effectively is crucial. A good student should be willing to examine himself in order to be aware of his level of deprivation and to strive to improve over time. This is because, according to a Malaysian Government study of graduates, around 60,000 graduates have yet to be approved for employment, and one of the causes for this difficulty is graduates' lack of communication skills. As a result, the objectives of this study are to (i) identify the level of difference in students' annoyance, whether caused by verbal or nonverbal communication; (ii) assess the difference in communication irritation between male and female students; and (iii) identify the communication situation in which students are most annoyed, whether in terms of group discussion, meeting, interpersonal interaction, public speaking, or writing. Random sampling was used to distribute 143 questionnaires to Polytechnic Sultan Azlan Shah students. According to the data, there was no significant difference in students' frustration levels between verbal and non-verbal communication. Furthermore, there was no statistically significant difference between male and female students in terms of communication annoyance. The findings then show that public speaking is the type of communication that students dread the most. This study's findings can be used by all lecturers and institutions to create the greatest types of education and program for supporting and encouraging students' talents to talk effectively, confidently, and courageously. Keywords: Communication, public speaking, non-verbal, verbal, writing

Genetic Analysis of Differentially Expressed Genes Associated with the Pathogenesis of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder present at birth and affects 1 in 36 children in the US. It causes symptoms like intellectual disability, lack of communication skills, delayed development of coordination and movement, and more. ASD is a spectrum disorder, and its complexity makes early diagnosis in children difficult as there are no known biomarkers that cause ASD. This project aims to identify genetic factors that may be associated with ASD. By splitting samples in the dataset accessed from the GEO database into a test group with ASD and a control group, this study used a statistical t-test to identify the top 250 differentially expressed genes with p-values < 0.05. These genes were entered in the STRING database to create a map of gene interactions and identify top pathways and biological processes. Analysis of pathways and biological processes led to findings that the differentially expressed gene ARF6 (ADP Ribosylation Factor 6) was active in all three pathways: RAS Signaling, Phospholipase D Signaling, and Salmonella Infection Pathways and played important roles in cellular functions. The experiment validated my hypothesis by providing evidence for a significant difference in gene expressions between ASD individuals and neurotypical individuals. ARF6 was found to be downregulated and involved in pathways and biological processes associated with ASD like immune and cell signaling dysregulation. The implication is If the ARF6 gene factor can be controlled to regulate ARF6 expression, the mutations that contribute to ASD can be suppressed through multiple pathways.

Pengaruh Penerapan Model Eliciting Activities (MEAs) terhadap Kemampuan Komunikasi pada Pembelajaran IPS Siswa Kelas 6 Sekolah Pioneer Depok

This research was motivated by the aim of knowing the social studies learning of students in Grade 6 of Depok Pioneer School that has not been achieved, one of which is communication skills. One of the factors for students' lack of communication skills is simply listening to the teacher's explanation, then taking notes and solving practice questions. This can result in students' knowledge and understanding being limited to the information provided by the teacher. So that a learning model is needed that is applied, namely by applying Model Eliciting Activities (MEAs). The purpose of this study is to determine whether the application of Model Eliciting Activities (MEAs) affects communication skills in social studies learning in grade 6 of Depok Pioneer School better than student communication skills using conventional learning in grade 6 of Depok Pioneer School. This type of research is quasi-experimental research. Sampling was carried out using pre-test post-test control group design. The population in this study amounted to 24 grade 6 students of Depok Pioneer School. Social studies learning activities use Model-Eliciting Activities for experimental classes, while in control classes social studies learning activities use Conventional learning. Data analysis using an independent sample T-Test test on post-test values of the experimental group and control group results showed changes in communication in social studies learning after using Model Eliciting Activities (MEAs). Based on the results of the study, it can be concluded that students' mathematical communication skills using Model Eliciting Activities (MEAs) are better than students' communication skills using conventional learning in Grade 6 of Depok Pioneer School.

Barriers to the completion of bachelor thesis for bachelor nursing students during their internship: A qualitative study from dual student and faculty perspectives

BackgroundBachelor thesis are among the most important ways of exercising Chinese nursing students' research skills and developing critical thinking. However, there is a mismatch between the expectations and abilities of clinical nursing teachers and nursing students. Exploring the impediments to nursing students' research skills can provide a basis for developing targeted improvements. ObjectiveTo identify barriers to the completion of research projects among nursing undergraduates during their internships from the dual student and instructor perspectives. DesignDescriptive qualitative design. SettingAffected by the COVID-19 pandemic, we conducted this study at a tertiary hospital in Fuzhou, Fujian Province. ParticipantsThe study was conducted using a purposive sample of 16 nursing interns and six instructors. MethodsData were collected through semi-structured interviews to provide nursing students and instructors with various perspectives. The collected data were analysed using thematic analysis methods. ResultsThis study included 16 students (two male and 14 female; age 21.75 ± 0.66 years), six instructors (age 34.33 ± 1.97 years), which was sufficient to reach data saturation. We identified 126 codes from the interview data and obtained seven subcategories among three categories: a) Lack of scientific research training: lack of clinical instructors' experience, lack of academic training courses, and lack of necessary scientific research resources support; b) Poor communication: excessive workload, poor instructor-student relationship, and lack of communication skills; and c) Lack of support systems: lack of support from other disciplines and negative coping patterns. ConclusionsThe findings of this study will help nursing interns develop an interest in scientific research throughout their internships. Reducing barriers will also strengthen teacher training programmes, improve the teaching process, promote teacher-student communication, and provide students with necessary social support.

Neuropsychological and Psychophysiological Studies in Logopsychotherapy: In Memory of J.M. Glozman

The article is devoted to research in logopsychotherapy related to J.M. Glozman. Logoneurosis is a disease that affects 1–2.5 % of the population according to various sources, which is why effective methods of rehabilitation are so important. One of the effective methods is group logopsychotherapy, a technique developed for adults and adolescents by Yu.B. Nekrasova in the 1960s and subsequently monogamously improved. A special stage in scientific research in the system of family group speech therapy began with the arrival of J.M. Glozman. In the groups of family logopsychotherapy, A.A. Kiselnikov conducted a systematic inter- and multidisciplinary study of the brain mechanisms of stuttering under the guidance of J.M. Glozman and V.A. Vartanov in 2004–2006, showing the determinacy of this speech disorder by many psychological variables. It has been shown that the disintegration of left-right hemisphere interactions in the realization of mental activity can be one of the mechanisms of stuttering. It was revealed that stuttering is not an isolated (purely peripheral) speech disorder, but occurs in a syndrome of specific mnestic, neurodynamic and motor defects reflecting dysfunction of the posterior and median structures of the brain (functional blocks I and III, according to A.R. Luria (1973)), and the symptoms of dysfunction decrease during complex speech therapy. In the course of 2015–2020 studies supported by the RGNF and RFBR, which were conducted with groups of stuttering people, as well as at the Neurocorrection Center with children with learning difficulties (Glozman, Karpova, Cheburashkin-Antipov, 2018b), it was also shown that inadequate methods of psychological protection in case of violations or lack of communication skills may be associated with defects the image of verbal communication. It has been shown that the appearance of stuttering is facilitated if the child has the phenomenon of crosslaterality. Psychophysiological studies have also shown the role of functional asymmetry of the brain in the formation of the disease, and the effectiveness of logopsychotherapy for the correction of logoneurosis has also been confirmed.

Barriers to providing quality care for patients with substance use disorders from the perspective of baccalaureate nursing students: A descriptive qualitative study

BackgroundWith Iran facing an epidemic in substance use disorders, nursing students are increasingly encountering people impacted by substance misuse. Providing care for this group brings with it many barriers and challenges. These serious barriers have not been a priority in Iranian nurse education. ObjectivesTo describe barriers to providing quality care for people with substance use disorders from the perspective of nursing students. DesignA descriptive qualitative study, using content analysis was used to address the study aim. Setting and participantsPurposive sampling was used to recruit participants. Participants were 34 baccalaureate nursing students from different academic semesters studying at two medical sciences universities in Iran. MethodsData were collected using semi-structured interviews from July 2022 to October 2022. Granheim & Lundman's method for qualitative content analysis was used to analyze data. ResultsThe barriers to providing quality care for people with substance use disorders were described through the major theme: “lack of communication skills and difficulty finding language for therapeutic communication with people with substance use disorders”. Based on nursing student perspectives, a lack of communication and language for therapeutic communication was described through the three barriers of: 1. “possessing or witnessing prejudiced attitudes and stereotypes”, 2 “negative role models”, and 3. “Knowledge deficit in self or others”. ConclusionThe result of this study showed that nursing students interact with people with substance use disorders through prejudiced attitudes, negative stereotypes, and knowledge deficits. Academic education should include practical techniques to reduce negative stereotypes and moral distress among nursing students as well as strategies to manage tough ethical situations and decrease prejudiced attitudes. Nurses and clinical educators must be attentive to their power to influence nursing students and should model appropriate unbiased behavior and language.

Managing knowledge against the tide: Barriers to knowledge management in the Chilean social and cultural context

In recent years, knowledge management has become increasingly relevant in Chile, with a growing number of organisations adopting policies and practices in this area. Despite this growth, it is known that many of the new initiatives in the field of KM do not thrive or face difficult start-up challenges, limiting the number of successful initiatives in this country. In this context, the aim of this research is to identify the main barriers faced by managers and practitioners in the implementation of KM initiatives in the context of Chilean organisations and to describe the ways in which these problems are addressed by them. This study was based on the review of twenty-six cases of knowledge management initiatives implemented between 2010 and 2022 in Chile, which were described and analysed using qualitative methodology. Among the main findings, it was found that the most important barriers to carrying out these initiatives coincide, to a large extent, with some of the characteristics of Chilean culture and society described in the literature of organisational studies, such as: lack of trust; large power distance in the organisational structure; lack of communication skills; paternalistic organisational culture, to mention a few. Also, one aspect worth highlighting is the traditional business culture that tends to focus on a "low cost" strategy and exploitation of raw materials, rather than investing in innovation. Scarce resources, problematic performance measurement and lack of knowledge management training for employees and managers were also mentioned as adverse factors. The relevance of this study lies in the fact that it provides insight into the main barriers faced by knowledge management initiatives in developing countries, specifically in a region such as Latin America, thus contributing to the development of this field in this region.

Reliability and Effectiveness of the Japanese Version of the Mobilization Quantification Score.

Background The mobilization quantification score (MQS) provides an opportunity to quantify the duration and intensity of mobilization therapy in the intensive care unit (ICU)and predictfunctional outcomes in ICU patients after surgery and stroke. MQS is a numerical measurement of early mobilization dose in the ICU, and its relationship with activities of daily living (ADL) dependence has been shown. We created and validated the Japanese version of the MQS using the endpoint ADL in a mixed population of patients in the ICU. Materials and methods In this prospective study, consecutive patients who were admitted to one of three ICUs of a tertiary care hospital in Japan, aged ≥18 years, and who received mechanical ventilation for >48 hours were enrolled. The Japanese version of the MQS was applied twice daily by an ICU physiotherapist and data recorded for analysis. The primary outcome was ADL dependence at hospital discharge, defined as a Barthel index (BI) of <70 or in-hospital death. The reliability among assessors was verified by calculating the interclass correlation coefficient (ICC) (2.1) for the average daily MQS. We performed a multiple logistic regression analysis to examine and identify a binary cutoff point for high-/low-dose rehabilitation. Results Of the 340 target patients, eight were aged <18 years, 109 had neurological complications, 11 had a BI <70 before admission, 79 had a lack of communication skills, 16 were terminally ill, eight did not complete the assessment during their ICU stay, 18 died in the ICU, and 53 denied consent. After 302 patients were excluded, 38 were included in the study.Six assessors, two at each hospital, measured the MQS in 38 patients. The ICC (2.1) for the MQS mean value was 0.98 (0.96-0.99) during the ICU stay. Logistic regression analysis using the mean MQS on admission to ICUs as an explanatory variable showed a significant association between increased MQS and decreased ADL dependence at discharge (odds ratio (OR): 0.76, confidence interval (CI): 0.61-0.96, adjusted p = 0.009). Logistic regression analysis using a high MQS on admission to ICUs as an explanatory variable showed a significant association between increased MQS and decreased ADL dependence at hospital discharge (OR: 0.14, CI: 0.03-0.66, adjusted p = 0.013). Conclusions We present a validated version of the Japanese MQS with a high inter-rater reliability that predicts ADL dependence at hospital discharge. The instrument can be used in future clinical trials in the ICU to control for the mobilization level in the ICU. The increased utilization of mobilization acutely in the ICU setting as quantified by the MQS may improve patient outcomes.

Examining the level of employee satisfaction with the performance of city managers (Case study: Baghershahr Municipality)

Objective: By referring to different organizations and taking a deep and expert look at the communication process in these organizations, this issue becomes apparent to every observer. One of the important and always noticeable problems in organizations that employees complain about is the lack of communication skills among their managers. One of the most important and key issues that has caught the attention of the body and the foundation of the organizational society in this period is the organizational commitment of the employees of an organization. This issue can have many factors and dimensions. The present study was conducted to investigate employee satisfaction with the performance of city managers of Baqershahr Municipality. Method: The statistical population of the research was all the employees of Baghershahr municipality, and Cochran's sample size formula was used to determine the sample size. Therefore, considering the error level of 0.05, the sample size was estimated to be 242 people. The data collection tool was a questionnaire. One-sample t-test, Pearson's correlation coefficient, multiple correlation and simultaneous multiple regression were used to analyze the data. Results: The results extracted from the above research emphasize the strong effect of job satisfaction on the commitment of the organization's employees. The managers of all levels of this municipality can know them better and more accurately and completely with the nobles and sufficient and accurate knowledge of the individual differences among their employees. As a result, taking actions that are most compatible with the heart desires of the employees increases their desire and motivation, satisfaction, and commitment in the direction of development and moving intelligently in the direction of the organization's goals. The level of satisfaction regarding the investigated components of job satisfaction is average, managers are high, and for the components related to welfare, it is below 40%. Conclusion: The results show that municipal employees have low and very low satisfaction with the amenities in the municipality.

Adherence to therapy in people with rheumatic and musculoskeletal diseases in Italy and the role of the digital health: results of an expert Delphi consensus survey.

To present the results of a Delphi consensus survey among Italian rheumatologists on adherence to therapy in people with rheumatic and musculoskeletal diseases (RMDs) in Italy and the role of digital health. A taskforce of 12 rheumatologists comprehensively discussed the applicability of the 2020 EULAR Points to Consider (PtCs) for Italian rheumatology practice and formulated 44 new country-specific statements. Through an on-line survey, the panellists voted on their level of agreement with the statements using a 10-point Likert scale (0: no agreement; 10: total agreement). A combination of two distinct criteria, a mean agreement level ≥8 and a percentage of at least 75% of responses with a value ≥8, was deemed acceptable. The consensus threshold was reached for 43 of the 44 country-specific statements. The following were acknowledged among the barriers to applicability of the recommendations: visit time too short; lack of resources; lack of a clear operational flow-chart; lack of communication skills and poor knowledge of techniques to improve patient adherence by healthcare professionals (HCPs). This consensus initiative helps contribute to more widespread implementation of EULAR PtCs in Italian rheumatology practice. Optimisation of visit time, greater availability of resources, specific training, use of standardised and validated protocols, and active involvement of patients represent the main goals. Digital health can provide valuable support for the application of PtCs and, more generally, in improving adherence. A collaborative effort between HCPs, patients and their associations, scientific societies, and policymakers is strongly advocated to overcome some of the barriers.

Analysis of School-Based Management and Principal Leadership in Improving Teacher Performance

This article discusses the general problem of low teacher performance in many schools in Indonesia, which can be seen from the school's consistently low qualitative average scores. The main goal of this article is to evaluate potential solutions to improve teacher effectiveness. The focus centers on two important aspects: the implementation of School Based Management (SBM) and the leadership style of the school principal. Identified challenges hindering teacher performance, including poor adaptation, lack of communication skills, and lack of openness to diverse opinions, will be examined. By using a descriptive analysis method with a qualitative approach, the author provides recommendations. The results of this article involve the implementation of a comprehensive principal leadership model that integrates visionary, democratic, and instructional elements, emphasizing support, collaboration, and commitment to ongoing professional development and motivation. The proposed model is expected to significantly improve teacher performance in schools in Indonesia.