Level Of Supervision Research Articles

Current management status of cleaning and disinfection for gastrointestinal endoscopy: a meta-analysis

Objective This study aimed to evaluate the current status of cleaning and disinfection management for digestive endoscopy, provide data for standardization processing techniques, and improve the quality of cleaning and disinfection. Methods Two reviewers independently and comprehensively searched the PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang, and CBM databases on February 1, 2023. The inclusion and exclusion criteria were strictly followed during the literature survey and data extraction. All observational studies detailing the current cleaning and disinfection management status for digestive endoscopy in hospitals were included. Meta-analysis was performed using STATA 16.0 software. Results After removing different articles, the meta-analysis finally included 54 articles associated with multiple countries. The authors favor auditing staffers to confirm compliance with guidelines. The meta-analysis results indicated a configuration rate of 76% (95% CI: 68–83%) for separate rooms designated for reprocessing; 79% (95% CI: 72–84%) for reprocessing rooms with adequate ventilation; 30% (95% CI: 24–36%) for automated endoscope washer-disinfectors; 68% (95% CI: 55–81%) for complete protective equipment usage; 90% (95% CI: 83–95%) for the configuration rate of endoscope and accessory storage cabinets; 50% (95% CI: 38–61%) for changing enzymatic-type detergents after each use; 51% (95% CI: 30–71%) for the use of purified or sterilized water for final rinsing; 80% (95% CI: 70–88%) for monitoring disinfectant concentration; 87% (95% CI: 80–93%) for microbial monitoring; and 44% (95% CI: 26–62%) for the usage of protective equipment. Conclusion The configuration of the automated endoscope washer-disinfector, non-standard cleaning and disinfection procedures, and a lack of occupational protection awareness among personnel responsible for cleaning and disinfecting digestive endoscopy were all apparent issues. It was suggested that all departments enhance their levels of management and supervision, standardize reprocessing procedures and quality control details, upgrade hardware facilities and spatial layouts, reinforce personnel training, and increase staff awareness of nosocomial infection risks.

Utilization of home-based care and its buffering effects between dementia caregiving intensity and caregiver burden in China.

Home-based care (HBC) services have gained global attention for their potential to reduce caregiver burden among informal caregivers of persons with dementia (PwDs), who experience high caregiving intensity. However, research on HBC and its effects on dementia caregiving in China remains limited. Data were collected from primary caregivers of PwDs in Jiangsu Province, China. Caregiving intensity and HBC utilization were measured using self-developed instruments. Caregiver burden was assessed by The Burden Scale for Family Caregivers-short. Factor analysis was employed to decompose HBC services. Hierarchical multiple regression analysed the moderating effects of HBC on the relationship between caregiving intensity and burden. A community sample of 318 caregiver and PwDs dyads was included. Caregivers averagely aged 62.16 years, with 61% being female, 84% not employed, and 66.2% having low income. PwDs aged 77.45 years averagely, with 52.8% being female and an average behavioural problems score of 42.27. Caregivers averaged 15.19 on response measures. The number and time spent on ADL-based tasks were positively associated with caregiver burden (β = 0.26, p < .001; β = 0.16, p < .01). However, attendance and time of supervision tasks were not significant predictors of burden. HBC services in China comprised four dimensions: Referral service, Household care, Skilled care, and Mental health service. While these did not directly predict caregiver burden, they moderated the associations between ADL-based tasks and caregiver burden (β=-0.25, p < .001; β=-0.24, p < .001; β=-0.23, p < .001; β=-0.20, p < .001), between time of ADL-based tasks and caregiver burden (β=-0.17, p < .001; β=-0.18, p < .001; β=-0.17, p < .001; β=-0.15, p < .01), and between the attendance at supervision tasks and caregiver burden (β=-0.11, p < .05; β=-0.20, p < .001; β=-0.17, p < .001; β=-0.17, p < .001). Only Referral service buffered the relationship between supervision time and caregiver burden (β = -0.13, p < .01). Informal caregivers of PwDs face high caregiving intensity and burden. HBC services may moderate this relationship, with different services playing varying roles. Further research is essential to explore the impact of supervision levels and develop effective strategies to enhance HBC services for dementia caregiving in China.

Focus on residents’ mental health: the Public Health Residents’ Anonymous Survey in Italy (PHRASI)

Abstract The ‘Public Health Residents’ Anonymous Survey in Italy” (PHRASI) represented the first study to specifically investigate mental health and its determinants among Italian public health residents (PHRs). Using a voluntary, anonymous, electronic, 88-item questionnaire, the PHRASI study generated evidence on well-being, eating disorders, sleep disorders, alcohol abuse, depressive symptoms, and anxious symptoms among PHRs. This highlights the correlation with sociodemographic, lifestyle, and work-related characteristics during COVID-19 pandemic. The data was collected in a nationally representative sample of PHRs enrolled in any of the four course years of Italian Public Health schools. The recruitment took place through the communication channels of the Medical Residents’ Council of the Italian Society of Hygiene and Preventive Medicine in the summer 2022. The key findings reveal prevalence rates of mental health conditions comparable to those seen in other healthcare workers during the COVID-19 pandemic: 61% of residents report depressive symptoms and 36% report anxious symptoms. The study also highlights a negative correlation of these symptoms with characteristics of the training and working environment, such as the level of supervision and peer-to-peer support. A stronger social network and higher levels of physical activity emerged to be positively associated with well-being and depression. These and other findings will be available in the final report of the survey that will be presented during the congress. PHRASI led the way to the Residents’ Mental health Investigation, a Dynamic longitudinal study in Italy (ReMInDIt), that aims to explore potential cause-effect relationships between risk/protective factors and mental health outcomes. This evidence could guide the scientific community, school directors, universities, and policymakers in the continuous process of improving the educational quality and working conditions of PHRs. Key messages • Residency training and work environment impact the mental health of the PHR workforce. • It is important to deploy concrete efforts into building healthy work environments and guarantee adequate training for PHRs.

Challenges of tertiary higher education in the framework of highly qualified teacher training in Ghana

The study of the features of the educational system of the Republic of Ghana in the context of the third stage of higher education is necessary for the further development of Russian-Ghanaian relations and the growth of partnership projects between higher educational institutions of Russia and Ghana. A proper understanding of the educational system of the Republic of Ghana, as well as the existing problems in the training of postgraduate students and possible ways to solve them, can help to improve the training process of highly qualified teaching staff. The purpose of the work is to reveal the problems of the third stage of higher education in the context of teacher training, and identify possible ways to solve them. The study analyses: 1) the characteristics of the higher education sector in the Republic of Ghana, in particular its tertiary level; 2) existing state initiatives in the country to improve the training of highly qualified teaching staff on the third stage of higher education; 3) statistics characterizing the current situation of postgraduate studies within the framework of higher education in the country; 4) the challenges emerging in the training of highly qualified teachers in sub-Saharan Africa, as well as their relevance to tertiary education in the Republic of Ghana. The study has identified the following difficulties that affect the process of writing and successful defense of dissertations: insufficient awareness of graduate students about further prospects for their employment with a PhD; insufficient financial security of postgraduate students; insufficient level of scientific supervision and excessive academic workload on supervisors of dissertation research. The study proposes solutions to the existing problems, such as increasing financial incentives for high-achieving PhD students, increasing control over the process of scientific supervision, placing greater emphasis on conducting interdisciplinary research and establishing partnerships with other countries of the African continent, and developing existing interaction with states outside Africa, including the Russian Federation.

Association between surgeon training grade and the risk of revision following unicompartmental knee replacement: An analysis of National Joint Registry data.

Unicompartmental knee replacements (UKRs) are performed by surgeons at various stages in training with varying levels of supervision, but we do not know if this is a safe practice with comparable outcomes to consultant-performed UKR. The aim of this study was to use registry data for England and Wales to investigate the association between surgeon grade (consultant, or trainee), the senior supervision of trainees (supervised by a scrubbed consultant, or not), and the risk of revision surgery following UKR. We conducted an observational study using prospectively collected data from the National Joint Registry for England and Wales (NJR). We included adult patients who underwent primary UKR for osteoarthritis (n = 106,206), recorded in the NJR between 2003 and 2019. Exposures were the grade of the operating surgeon (consultant, or trainee) and whether or not trainees were directly supervised by a consultant during the procedure (referred to as "supervised by a scrubbed consultant"). The primary outcome was all-cause revision surgery. The secondary outcome was the number of procedures revised for the following specific indications: aseptic loosening/lysis, infection, progression of osteoarthritis, unexplained pain, and instability. Flexible parametric survival models were adjusted for patient, operation, and healthcare setting factors. We included 106,206 UKRs in 91,626 patients, of which 4,382 (4.1%) procedures were performed by a trainee. The unadjusted cumulative probability of failure at 15 years was 17.13% (95% CI [16.44, 17.85]) for consultants, 16.42% (95% CI [14.09, 19.08]) for trainees overall, 15.98% (95% CI [13.36, 19.07]) for trainees supervised by a scrubbed consultant, and 17.32% (95% CI [13.24, 22.50]) for trainees not supervised by a scrubbed consultant. There was no association between surgeon grade and all-cause revision in either crude or adjusted models (adjusted HR = 1.01, 95% CI [0.90, 1.13]; p = 0.88). Trainees achieved comparable all-cause survival to consultants, regardless of the level of scrubbed consultant supervision (supervised: adjusted HR = 0.99, 95% CI [0.87, 1.14]; p = 0.94; unsupervised: adjusted HR = 1.03, 95% CI [0.87, 1.22]; p = 0.74). Limitations of this study relate to its observational design and include: the potential for nonrandom allocation of cases by consultants to trainees; residual confounding; and the use of the binary variable "surgeon grade," which does not capture variations in the level of experience between trainees. This nationwide study of UKRs with over 16 years' follow up demonstrates that trainees within the current training system in England and Wales achieve comparable all-cause implant survival to consultants. These findings support the current methods by which surgeons in England and Wales are trained to perform UKR.

EP3 - Reducing general surgical inpatient falls: an allied health professionals’ perspective

Abstract Aims Understand the current view of inpatient falls on a general surgical ward from allied health professionals. Identifies ways to reduce inpatient falls in general surgery. Methods Staff from two acute surgical wards were surveyed in December 2023. Seven questions used Likert scales (1-to-5, 1=Not preventable at all/significantly reduces the risks of falls/not confident at all/unimportant 5= Entirely preventable /significantly increases the risks of falls/very confident/important). One question focused on recent fall involvement. Modal values were taken. Data was inputted using Google Docs and analysed in Microsoft Excel. Results 13 responded (5 nurses, 4 health care support workers, 4 sisters). 7/13 had been involved in a fall in the last six months. Staff felt that the current post-inpatient fall proforma slightly reduces further falls risk. Factors that staff felt significantly increases the risks of falls were reduced mobility, delirium, falls history and impaired cognition. Factors that staff felt significantly reduces the risk of falls were, identifying patients at risk of falls, measuring lying and standing blood pressure, identifying the level of supervision for patient mobilisation, therapy assessment, initiating geriatric/falls review of high-risk falls patients, medication review, education of patients on avoiding falls and early senior clinician involvement in falls. Most staff felt mostly confident (4) knowing how to reduce the risk of falls and managing falls. Conclusions Most staff are comfortable managing falls. The falls proforma needs further development incorporating areas identified in this study to help reduce inpatient falls.

Advances and challenges in endoscopy training: A mixed methods study among endoscopy trainers in the Netherlands

Abstract Background and study aims Variation between trainers in providing traditional gastrointestinal endoscopy training, in which residents learn endoscopy by doing under the supervision of endoscopy trainers, may cause differences in endoscopy competence between residents. In this study, we explored endoscopy trainers’ views on the current status and desired future best practices regarding endoscopy training. Methods This mixed-methods study comprised quantitative survey data collected from 158 endoscopy trainers working in 26 gastroenterology teaching hospitals in the Netherlands and semi-structured interviews with 15 gastroenterology residency (associate) program directors (PDs). Survey data were analyzed using descriptive statistics and interview results with thematic analysis. Results There was considerable variability in endoscopy training practices between teaching hospitals in the structure of endoscopy supervision, criteria used to determine the level of supervision, and participation of trainers in endoscopy teaching courses. Interview participants agreed that an endoscopy training supervisor requires several teaching strategies, highlighting the importance of formal education in endoscopy teaching. Interview participants perceived self-regulated learning strategies as essential for residents to learn endoscopy effectively. The perceived main barriers to effective supervision were a lack of time and heavy workload. Participants expressed the desire for more standardization in endoscopy training programs between teaching hospitals. Conclusions Considerable variability in endoscopy training practices between gastroenterology teaching hospitals was identified. Formal education on endoscopy teaching, promotion of self-regulated learning, and standardization of endoscopy training programs and supervision practices have the potential to improve future endoscopy training.

Investigating occupational accidents based on the Human Factors Analysis and System Classification (HFACS) method: a case study in an industrial and mining company

Background and aims: Human errors are a significant issue in various work environments, including industry and mining. This study aims to investigate occupational accidents in a large industrial-mining company based on the human factors analysis and classification system (HFACS) method. Materials and methods: The study conducted a retrospective longitudinal analysis of 253 mining industrial accidents from 2011-2019 using the Human Factors Analysis and Classification System (HFACS). Descriptive statistics, such as frequency and percentage of subgroups at each level, were calculated using the HFACS method and SPSS software. Results: The type of accident that occurred was related to throwing/collision or contact with a foreign object, which resulted in a total of 232 injured people and one dead person. Statistical analysis showed no significant link between the accident type and the educational levels of those involved, as indicated by a P-value greater than 0.05.Still, it showed a significant relationship with three other demographic variables: age, marital status, and work experience (P-Value˂0.05). The highest frequency and percentage of the causes of accidents were also due to organizational effects and unsafe practices. Discussion and conclusion:. The study found that the frequency of human errors in the levels of unsafe supervision and unsafe practices significantly contributed to the occurrence of occupational accidents in the company. Analyzing accidents and understanding the relationship between causal factors at the four levels of the HFACS method is vital for implementing effective strategies to reduce accidents.

Improvement of legal guarantees of legality in the service activity of administrative courts in Ukraine

The scientific article identifies the peculiarities of improving the service activity of administrative courts in Ukraine. Special guarantees include legal (legal) guarantees of legality of service activities of administrative courts in Ukraine, which represent specific legal means and internal legal mechanisms, which are a real embodiment of legality in the legal sphere. Legal guarantees of the legality of service activities of administrative courts in Ukraine include: completeness and effectiveness of legal norms; a high level of control and supervision over the implementation of legality; quality activity of competent authorities to ensure legality; improvement and improvement of legal practice; effectiveness of measures of legal responsibility. The author has highlighted the areas of effectiveness of the implementation of legal guarantees of the service activity of administrative courts in Ukraine, namely: to improve the administrative and legal regulation and the mechanism of control on the part of public administration subjects through the delimitation of their competence; the procedure for exercising the powers of state authorities and local self-government bodies regarding control in service activities; to develop and adopt the Law of Ukraine «On Judicial Services», in which to define an exhaustive list of government entities that would carry out control in this area, their powers, forms and procedures of such activity, methods, methods of implementation and responsibility in case of abuse of control, etc. ; strengthening public control and creating effective feedback with civil society organizations through the development and implementation of the project «Proliferation of non-state monitoring of service activities of administrative courts in Ukraine», which will improve the quality of the provision of court services by relevant entities of public administration, etc.

Towards sustainable development: Can green digital finance become an accelerator for reducing pollution and carbon emissions in China?

As a fusion of financial ''digitalization'' and ''greening'', green digital finance is crucial for ecological quality enhancement. Based on panel data from 285 cities in China spanning 2011 to 2021, this study aims to examine the synergistic impact of Green Digital Finance (GDFO) on Pollution and Carbon Reduction (PCR). The two-way fixed effect model, moderated effect model, and threshold model are employed to study the direct, transmission, and non-linear effects of GDFO on PCR. Results indicate that GDFO significantly enhances PCR in urban areas, and this conclusion remains valid after several robustness tests. Mechanically, encouraging green technology innovation, promoting industrial structure upgrading, and enhancing financial supervision are effective channels for strengthening the impact of GDFO on PCR. At varying levels of green digital finance and financial supervision, the marginal impact of GDFO on PCR exhibits double threshold characteristics in the form of "U-shaped" and "inverted U-shaped". Furthermore, the impact of GDFO on PCR is more pronounced in the eastern and western regions, resource cities, and cities with a high level of financial development, excellent digital infrastructure, and robust environmental regulation. This study offers theoretical support and empirical evidence for deepening the GDFO to promote PCR at the city level.

Role of green finance in regional heterogeneous green innovation: Evidence from China

Green finance plays a critical role in promoting regional green innovation. However, the precise influence of green finance on diverse facets of green innovation remains underexplored. This study empirically analyses the diverse effects of green finance on heterogeneous green innovation by applying the negative binomial model, the threshold model, andthe spatial error model using China’s regional data from 2010 to 2019. The results indicate that green finance has a positive impact on regional green innovation performance, primarily through significant contributions to fossil energy carbon reduction, energy conservation and recovery, and clean energy technology innovation. The effect of green finance is also influenced by the level of local environmental supervision, exhibiting a significant threshold effect. In addition, the development of green innovation in the region can have a siphoning effect on the resources of surrounding areas, hindering their innovation development. These findings highlight the necessity for strategic government policy-making, which should leverage the diverse impacts of green finance on various forms of green innovation. Customizing green financial instruments to suit regional environmental regulatory conditions and the green innovation levels of neighboring regions could significantly aid in promoting regional green transformation and growth.

Pulling Back the Curtain: A Cross-Sectional Analysis of Medical Spas in Missouri.

There is very little legislation defining the degree of supervision and training required to perform cosmetic procedures in Missouri. The medical spa industry, particularly the volume and complexity of cosmetic procedures offered by medical spas, has seen significant growth in recent years. To better understand the medical spa workforce, depth, and breadth of aesthetic procedures offered by medical spas in Missouri. Cross-sectional study based on standardized telephone interviews, supplemented by website data. Survey responses were recorded, streamlined, and analyzed. Although 94.59% of medical spas in Missouri are affiliated with a physician, only 22.52% of medical spas have a physician on-site for administration of cosmetic treatments. Nonphysician staff members who administer cosmetic services generally outnumber physician affiliates at Missouri medical spas, with the average ratio of nonphysician staff who administer cosmetic services to MD/DO affiliates per spa being 2.1:1. There is significant variability in the level of training and supervision of medical spa staff performing cosmetic treatments in Missouri. As the medical spa industry continues to grow and high-risk cosmetic procedures become more commonplace, consistent statewide regulation of medical spas is needed to prevent harmful patient outcomes.

Optimization of Tax Collection Supervision in Increasing Local Original Revenue (PAD) by Gorontalo City Finance Agency

This study aims to determine the Optimization of Tax Collection Supervision in Increasing Regional Original Revenue (PAD) by the Gorontalo City Finance Agency. This research method uses descriptive qualitative research. The data collection techniques used are observation, interview, and documentation techniques. In accordance with the type of research used is qualitative analysis techniques. research results in the form of interviews conducted with research informants about Optimizing Supervision of Restaurant Tax Collection in Increasing Regional Original Revenue (PAD) by the Gorontalo City Finance Agency. The sub-focus used are: implementation standards, level of supervision, responsibility. From the statements or results of research with several informants above and from the observations of researchers, it shows that the standard implementation of restaurant tax collection by the Finance Agency has not been implemented optimally. Based on several statements or results of interviews with informants and from observations of researchers, it shows that the level of supervision carried out by the finance agency is still not optimal. From the results of interviews with several informants above, and from the observations of researchers, it shows that the responsibility of taxpayers is still a little less and has not reached a perfect number and the responsibility of the Finance Agency is also still not optimally carried out, this happens because there are still many taxpayers who do not understand the tools or sites they use in making transactions. This is one of the reasons why restaurant tax collection has not been optimized in increasing local revenue (PAD) in Gorontalo City.

Perceptions of undergraduate nursing students regarding their competency in administering medications: A qualitative study

AimThis study aims to explore and describe self-reported perceptions of nursing students’ competence in the administration of medication. BackgroundMedication errors are a significant concern in hospitals, as they can result in serious harm and even death for patients. Nursing students play a crucial role in administering medication and preventing errors, but they are also prone to making mistakes. While numerous studies have extensively examined the factors that contribute to medication errors, few have focused on the assessment of competency among nursing students. DesignThis study employed a qualitative exploratory and descriptive design. MethodsA total of 10 undergraduate nursing students at a higher education institution consented to participate in face-to-face, semi-structured individual interviews. Data were collected between August and September 2022 using an interview guide. The interviews were audio recorded and analysed using Braun and Clarke's six steps of thematic analysis. ResultsThe study revealed two major themes: (1) ‘Perceived barriers to competency’, which include participants' concerns regarding making errors, knowledge in pharmacology, self-efficacy in mathematics and level of supervision; and (2) ‘Mechanisms for improvement’, which centre on enhancing simulation proficiency, improving supervision and integrating pharmacology education in year two of nursing training. ConclusionThe study findings suggest that student nurses face various barriers to competence, such as a fear of making mistakes, a lack of pharmacology knowledge and low self-confidence in calculating drug dosages. To address these issues, prioritising supervision is crucial to facilitate student learning and ensure safety. Future research should consider investigating the perspectives of nurse educators on pharmacology curricula.

Research on risk data analysis of hazardous chemical vessels based on stream computing

Abstract To effectively improve the safety supervision and information management level of vessels carrying hazardous chemicals, the maritime management department is promoting the construction of hazardous chemical vessel monitoring systems based on artificial intelligent technology for hazardous chemical terminals and shipping companies in their jurisdiction. It can identify specific risks and transmit the risk data in real-time to the data center. To analyze data in real-time, a risk data analysis platform for hazardous chemical vessels based on stream computing is designed and implemented. The platform acquires vessel automatic identification system (AIS), risk, basic information, and other data. Based on the stream computing of Flink, it evaluates the risk status of vessels in real time, counts the risk data, and displays the results in the form of charts. The analysis of risk data for hazardous chemical vessels helps maritime management departments to track the real-time navigation status of key vessels, timely identify potential safety hazards, and effectively improve the level and efficiency of safety supervision.

Intervention time and adverse events in a canadian epilepsy monitoring unit: An updated audit

BackgroundOptimizing patient safety in the epilepsy monitoring unit (EMU) has become a topic of increasing interest. We performed an audit of our center's new single-floor EMU, assessing intervention rate (IR), intervention time (IT), and adverse events (AEs). MethodsA prospective study was conducted on all clinical seizures of patients admitted over a one-year period at our Canadian academic tertiary care center's new single-floor EMU. This single-floor EMU was supervised by EEG technologists during daytime (similar to the old set-up) and beneficiary attendants during nighttime/weekends (versus live video feed to the central nursing station on the neurology ward previously). Among 153 admissions, 79 were analyzed, and a total of 537 seizures were reviewed to assess IR, IT, and AEs. Univariate comparisons were performed with our double-floor EMU, which we reported in a previous publication. ResultsIn our new single-floor EMU, the IR was 61.1 % and overall median IT was 29.0s (19.0s–45.9s). The AE rate was 4.8 %. Compared to previously reported numbers for our old double-floor EMU (IR = 27.8 %; IT = 21.0s; AE = 1.2 %), the IR was significantly higher ((p < 0.001) but unexpectedly, the median IT was higher (p < 0.001) as well as the AE rate (p < 0.001). ConclusionThis prospective evaluation revealed a small but non-negligible rate of complications in our EMU, higher than our prior retrospective audit. Heightened levels of supervision in our new single-floor EMU led to higher IR. This may have led to artificially longer ITs.

Study on the Influences of Inter-Governmental Information Flow and Interdepartmental Collaborative Supervision on Pork Quality: A Case Study in China.

To study the influences of the degree of interdepartmental collaborative supervision on the behavioral strategy selection of pig farmers, pig slaughterers, and pork processing manufacturers in the pork supply chain system, this study established a three-party evolutionary game model involving pig farmers, pig slaughterers, and pork processing manufacturers based on the social co-governance framework by focusing on the interdepartmental information sharing mechanism and cooperative governance. Here, we examined how the degree of collaborative supervision among government departments influences the behavioral strategy selection of these parties by focusing on key mechanisms such as information sharing and interdepartmental collaborative governance. Our findings revealed that within a social co-governance system, the strategic choices of the three entities in the pork supply chain closely correlate with the coordination level of collaborative supervision among government departments, particularly through information-sharing mechanisms. Additionally, the strategies are influenced by market-based contract supervision among entities, consumer reporting intensity, and the collaborative governance capabilities of the government, market actors, and consumers. Higher levels of social co-governance are associated with fewer risky links in the pork supply chain and reduced overall risk. Key factors affecting the behavioral strategy selection of the subjects in the pork supply chain include interdepartmental collaborative governance among government departments (e.g., optimizing random inspection frequencies, adjusting economic penalties, and disclosing enterprise market credit information via information sharing mechanisms), consumer complaint probabilities, and the intensity of mutual supervision among enterprises. Therefore, to enhance pork supply chain quality and mitigate risks, it is crucial to enhance the coordination of collaborative supervision among government departments, encourage consumer reporting, and improve market-based mutual supervision mechanisms among upstream and downstream subjects in the supply chain.

When Charismatic Leadership Loses its Luster: Examining the Interactive Effect of Charismatic Leadership and Abusive Supervision on Follower Prosocial Motivation and Citizenship Behavior

We develop a multilevel framework that examines the simultaneous co-occurrence of charismatic leadership and abusive supervision and how they jointly diminish followers’ prosocial motivation. Furthermore, we tested a mediated moderation model to examine whether followers’ prosocial motivation mediates the link between charismatic leadership and followers’ citizenship behavior under high and low levels of abusive supervision. Results from a field study based upon 296 employees and 44 supervisors in 44 teams across three organizations provided support for the predicted relationships. Charismatic leadership positively influenced followers’ prosocial motivation when abusive supervision was low but not high. Furthermore, followers’ prosocial motivation mediated the link between charismatic leadership and followers’ organizational citizenship behavior when abusive supervision was low but not high. We discuss theoretical implications for abusive supervision's neutralizing effect, identify avenues to advance charismatic leadership and prosocial motivation research, and provide recommendations for practitioners to cultivate an environment that nurtures employees’ prosocial motivation.

Satisfaction and wellbeing of general surgery trainees in the Saudi Arabian residency educational environment: A mixed-methods study

BackgroundSurgical residency training is prominently demanding and stressful. This can affect the residents' wellbeing, work-life balance and increase the rates of burnout. We aimed to assess rates of satisfaction and burn-out among GS residents in the national training programs and provide a subsequent in-depth analysis of the potential reasons. MethodA sequential explanatory mixed-methods study was conducted using an online survey and virtual interviews. The validated abbreviated Maslach Burnout Inventory (aMBI) was used to assess burnout while satisfaction was assessed via 5-points Likert scale. ResultsAfter excluding incomplete responses from the total 74 received, 53 were analyzed. The average participant age was 27.4 ± 2 years, with females comprising 52 % of the sample. Junior residents made up 58.5 %, and nearly half −45 %- considered quitting GS training. Moderate to high burnout rates were noted on each aMBI subscale, ranging from 41.7 % to 62.5 %. The majority of residents expressed dissatisfaction with the level of research engagement (81.1 %), supervision, and mentorship. However, operative exposure was a source of satisfaction. Dissatisfaction rates with intra-operative learning, academia, teaching, and clinical exposure were 62.3 %, 52.8 %, 50.9 %, and 35.8 %, respectively. Interviews revealed surgical case flow and a friendly work environment as major satisfaction sources. Conversely, lack of academic supervision and suboptimal hands-on training were major dissatisfaction sources. ConclusionDissatisfaction and burn-out is prevalent among national GS training programs. Sub-optimal educational delivery and low-quality hands-on operative exposure -rather than lack of exposure to cases- seem to be the culprit.

Deriving phenotype-representative left ventricular flow patterns by reduced-order modeling and classification

BackgroundExtracting phenotype-representative flow patterns and their associated numerical metrics is a bottleneck in the clinical translation of advanced cardiac flow imaging modalities. We hypothesized that reduced-order models (ROMs) are a suitable strategy for deriving simple and interpretable clinical metrics of intraventricular flow suitable for further assessments. Combined with machine learning (ML) flow-based ROMs could provide new insight to help diagnose and risk-stratify patients. MethodsWe analyzed 2D color-Doppler echocardiograms of 81 non-ischemic dilated cardiomyopathy (DCM) patients, 51 hypertrophic cardiomyopathy (HCM) patients, and 77 normal volunteers (Control). We applied proper orthogonal decomposition (POD) to build patient-specific and cohort-specific ROMs of LV flow. Each ROM aggregates a low number of components representing a spatially dependent velocity map modulated along the cardiac cycle by a time-dependent coefficient. We tested three classifiers using deliberately simple ML analyses of these ROMs with varying supervision levels. In supervised models, hyperparameter grid search was used to derive the ROMs that maximize classification power. The classifiers were blinded to LV chamber geometry and function. We ran vector flow mapping on the color-Doppler sequences to help visualize flow patterns and interpret the ML results. ResultsPOD-based ROMs stably represented each cohort through 10-fold cross-validation. The principal POD mode captured >80 % of the flow kinetic energy (KE) in all cohorts and represented the LV filling/emptying jets. Mode 2 represented the diastolic vortex and its KE contribution ranged from <1 % (HCM) to 13 % (DCM). Semi-unsupervised classification using patient-specific ROMs revealed that the KE ratio of these two principal modes, the vortex-to-jet (V2J) energy ratio, is a simple, interpretable metric that discriminates DCM, HCM, and Control patients. Receiver operating characteristic curves using V2J as classifier had areas under the curve of 0.81, 0.91, and 0.95 for distinguishing HCM vs. Control, DCM vs. Control, and DCM vs. HCM, respectively. ConclusionsModal decomposition of cardiac flow can be used to create ROMs of normal and pathological flow patterns, uncovering simple interpretable flow metrics with power to discriminate disease states, and particularly suitable for further processing using ML.