License Renewal Research Articles

Chiropractic residencies and fellowships as continuing education: a review of chiropractic state boards policies

ObjectiveTo review United States chiropractic state boards acceptance of chiropractic residencies and fellowships as continuing education (CE).MethodsBetween February 2024 and April 2024, board websites and accompanying policy documents for all 50 states and the District of Columbia were manually searched for content related to residencies and fellowships and whether they were considered CE. Information regarding CE credit requirements for new licensees was also collected. Results were tabulated in a spreadsheet and descriptive analysis was performed. Consensus among a minimum of 5 of 6 investigators was sought.ResultsFour states (Arizona, Indiana, Kansas, and Minnesota) accept residencies or fellowships for CE credit, 6 states possess unclear regulatory language regarding these programs, and 41 states make no mention of these training programs among approved CE. Twenty-one states required CE credits during a licensee’s initial renewal period, 1 state was unclear based on website content alone, and 29 states did not mandate CE for initial license renewal. More than 90% (19/21) of states that require CE for a licensee’s first renewal do not or are unclear if they accept residencies or fellowships for credit.ConclusionFew chiropractic state boards currently accept residencies and fellowships as approved CE. As the number of these postdoctoral training programs for chiropractors grow, more state boards may be asked to determine their CE policies on them.

Online driver license renewal and road user injury and fatality in Washington State

Objectives Washington State implemented a new policy in 2004 that allowed drivers younger than 70 years old to renew their driver license by mail or online at every other renewal. Drivers aged 70 years and older were still required to renew in-person every 6 years. The purpose of this study was to evaluate whether this policy change was associated with motor vehicle crash (MVC) injury and fatality among drivers, non-drivers, and all road users aged 45–69 years. Methods Controlled interrupted time series analysis models were fit to compare injury and fatality rates for these road users affected by the requirement to older road users not affected by the requirement (70 years and older). Differential level and slope changes in injury and fatality rates were used to estimate associations with the change in the license renewal requirement. Results We did not find evidence that implementation of online driver license renewal in Washington was associated with increased injury or fatality rates among drivers, non-drivers, or all road users aged 45–69 years relative to those aged 70 years and older. Conclusions Allowing driver license renewal online or by mail at every other renewal appears to be a safe strategy for less restrictive driver licensing for drivers aged 45–69 years. Future research should continue to evaluate the potential impacts of in-person and online renewal policies.

Transformasi Layanan SIM Nasional Presisi (SINAR) melalui Inovasi Aplikasi Digital Korlantas Polri di SATPAS Colombo Surabaya

The implementation of public services in Indonesia is regulated by Law Number 25 of 2009, namely a series of activities to meet service needs in accordance with regulations for every citizen and resident. This service includes goods, services or administrative services provided by public service providers. In addition, through Presidential Instruction Number 3 of 2003 concerning national policies and strategies for developing E-government, communication and information technology is utilized in government processes to increase the efficiency and effectiveness of government administration. One form of e-government-based public service innovation introduced by the National Police Chief is the National Police Traffic Corps Digital application in the form of the SINAR Service with the aim of providing more effective and efficient public services in the driving license (SIM) renewal process which can be accessed online. The aim of this research is to describe the Digital Application Innovation of the National Police Traffic Corps in the SINAR (Precision National Driving License) Service at SATPAS Colombo Surabaya. This research uses a qualitative descriptive approach. The research results show that: 1) Relative Advantage, This innovation was accepted quickly, even though there were internal challenges related to the applicant's signals and devices. 2) Compatibility, acceptance of innovation is fast, but some people still don't know about SINAR services because socialization is not yet comprehensive. 3) Complexity, innovation is accepted quickly, but there are technical problems such as lag or bugs when uploading photos. 4) Triability, positive and rapid acceptance of the innovation due to internal testing by the development team, Satpas staff, as well as a two-week trial with SIM applicants that successfully identified and fixed problems, ensuring the application meets user needs. 5) Observability, innovation is accepted quickly in society, but there are still deficiencies in data collection on applicant queues by security officers that need to be considered.

The Role of Nursing Guidelines on Successful License Renewal for Nurses and Midwives in Ubungo District Public Hospitals in Tanzania

In the recent years, nurses and mid wives are struggling to keep their knowledge current knowledge and skills current and relevant through to changing requirements and situations. Through engaging in continuing professional development (CPD), care givers become updated knowledge and practice to provide quality care to patients. This study sought to unveil the role of CPD on license renewal of midwives and nurses with a special focus on Ubungo district as Ubungo has more health Centres as compared to other districts in Dar es Salaam. Specifically, the study sought to determine the role of nursing guidelines on successful license renewal for Nurses and Midwives in Ubungo District Public Hospitals, The study was guided by the Kirkpatrick Model as the theoretical framework. The study used descriptive research design while simple random and purposive sampling techniques were used to select members of sample size who were 99 respondents. The target population of the study included all public hospitals, dispensaries and health centres located in the Ubungo district. The data was collected using documents review, in-depth interview, and structured interviews, and then analyzed using content analysis, narrative analysis, and descriptive analysis. Findings revealed that the CPD acquisition and license renewal guidelines are available at the Tanzania nursing and midwifery council(TNMC) website, however, they require registration and login to access them. The license acquisition process was through paper document submission at the TNMC office and later on changed to online in 2022. Apart from insufficient computers and limited internet access, some challenges result from nurses and midwives negative attitude towards license renewal as they tend to not renew them until there is a tactical advantage such as a promotion. Management staff at the hospitals also does not focus on license renewal as they focus more on accomplishment of daily tasks, and only care when a malpractice occurs. CPD points determine the eligibility of the license renewal applicant. The study concludes that the online availability of CPD guidelines is a good way of reaching all stakeholders. The study recommends awareness raising activities regarding access to the guidelines, raise more awareness regarding the online license renewal system, and design more effective and efficient means of stakeholder outreach.

Gender differences in factors associated with rural health care practice in Minnesota.

To understand gender differences in factors affecting rural health care workforce to inform the development of effective policies and recruitment strategies to address rural health care workforce shortages. A cross-sectional survey of health care professionals (including Advanced practice registered nurses (APRNs), physicians, physician assistants (PAs), and registered nurses (RNs)) in Minnesota was administered by the Minnesota Department of Health from October 18, 2021, to July 25, 2022, during their professional license renewal. The main outcome was whether or not the respondent was practicing in a rural area. The effects of factors associated with rural practice were estimated using binary logistic regression models, and subsequently subgroup analysis was conducted by gender across the four health care professions. Results show that although there were significant gender differences in some factors (growing up in a rural area and family considerations were more likely to influence women's decisions than men's, whereas men were more likely to be influenced by the prospect of having autonomy and broad scope of practice than women), these differences became insignificant when the four health care professionals were analyzed separately suggesting that overall gender differences observed were almost entirely explained by profession differences. Gender differences do not significantly influence the factors impacting rural practice. However, being raised in a rural environment emerges as the most influential predictor of rural practice underscoring the importance of involving rural residents of all genders in health care practice.

MICRO-СREDETIALS IN SOCIAL WORK: INTERNATIONAL EXPERIENCE

Micro-credentials, as a contemporary form of short-term learning, have become a vital tool for enhancing professionals' qualifications across various fields. This research aims to analyze the international experience of implementing micro-credentials in social work, determining their content and advantages, and forming recommendations for their use in the national system. The experiences of the USA and Ireland demonstrate how micro-credentials can contribute to the development of professional skills and adaptation to modern challenges. In the USA, micro-credentials are offered to both university students and practicing social workers. They can be standalone programs or part of broader educational initiatives, allowing for flexible learning approaches. Ireland focuses on continuous professional development for social sector workers, implementing micro-credentials through online courses with fixed dates. Comparing these countries' approaches highlights several key points. In the USA, the emphasis is on additional specialization and license renewal for social workers, while in Ireland, micro-credentials target innovations in social work and policy, along with supporting professional development. Both countries use program accreditation to ensure quality and national recognition. For Ukraine, implementing micro-credentials in social work can be a significant step in enhancing professionals' qualifications, especially given rapid social and technological changes. Essential tasks include creating flexible educational programs, actively involving practicing professionals, fostering partnerships between universities and organizations, and ensuring transparency in micro-credential information. Additionally, there is a pressing need for implementing a system of continuous professional development, regulating requirements for social service providers, and creating career opportunities for social workers, incentivizing micro-credential attainment.

Continuing Professional Development Program in Health Facilities in Rwanda: A Qualitative Study on the Perceptions of Health Professionals.

Continuous professional development (CPD) is an important pillar in healthcare service delivery. Health professionals at all levels and disciplines must continuously update their knowledge and skills to cope with increasing professional demands in the context of a continuously changing spectrum of diseases. This study aimed to assess the CPD programs available in healthcare facilities (HFs) in Rwanda. Semi-structured interviews were conducted using purposive sampling. Accordingly, the respondents belonged to different categories of health professionals, namely nurses, midwives, laboratory technicians, pharmacists, general practitioners, and specialist doctors. Thirty-five participants from district, provincial, and national referral hospitals were interviewed between September and October 2020. A thematic analysis was conducted using Atlas ti.7.5.18, and the main findings for each theme were reported as a narrative summary. The CPD program was reported to be available, but not for all HPs and HFs, because of either limited access to online CPD programs or limited HF leaders. Where available, CPD programs have sometimes been reported to be irrelevant to health professionals and patients' needs. Furthermore, the planning and implementation of current CPD programs seldom involves beneficiaries. Some HFs do not integrate CPD programs into their daily activities, and current CPD programs do not accommodate mentorship programs. The ideal CPD program should be designed around HPs and service needs and delivered through a user-friendly platform. The motivators for HPs to engage in CPD activities include learning new things that help them improve their healthcare services and license renewal. This study provides an overview of the status and perceptions of the CPD program in HFs in Rwanda and provides HPs' insights on the improvements in designing a standardized and harmonized CPD program in Rwanda.

SURFACE MOBILITY SOLUTION

In the Nagpur City of Maharashtra, the barrier of transportation in the daily life. Amidst mixture of sounds of honking horns and bustling streets, an intricate web of challenges come face to face with drivers and transportation professionals at every turn. As I delved into Nagpur's mobility landscape, engaging with drivers. The journey of exploration began with a simple premise: to understand the quality of being complex mobility challenges from the perspective of those entrenched in the frontline of transportation. Through extensive interviews and surveys, I sought to peel back the layers of complexity surrounding issues that impact drivers' livelihoods, schedules, and overall efficiency. What emerged from these interactions were recurring themes, echoing the sentiments of drivers navigating the labyrinthine streets of Nagpur: Documentation and Permit Predicaments: A maze of paperwork and bureaucratic hurdles often impedes the seamless flow of operations for drivers. From license renewals to permit applications, navigating the labyrinth of documentation requirements proves to be a formidable task, with delays rippling through the fabric of daily operations. Route Riddles: In a city where every turn can make the difference between timely arrival and frustrating delays, the lack of familiarity with optimal routes emerges as a significant challenge. For drivers, deciphering the shortest path from point A to point B is akin to navigating through a complex puzzle, where each intersection presents a myriad of choices, each with its own consequences. time Constraints and Efficiency Dilemmas: In the world of transportation, time is money, and every minute lost to loading and unloading delays translates into tangible losses for drivers. Whether it's waiting in line at a distribution center or grappling with the intricacies of cargo handling, the specter of inefficiency looms large, casting a shadow over the profitability of operations. Technological Turbulence: As the world hurtles towards an increasingly digitized future, the divide between technological proficiency and traditional practices widens. For drivers grappling with the complexities of GPS navigation systems and digital documentation platforms, the learning curve can be steep, posing yet another barrier to efficiency and competitiveness.

Vehicle Theft Authentication System

This thesis presents a robust security system designed to tackle the escalating issue of vehicle theft and unlicensed driving. By integrating a suite of cutting-edge technologies including Arduino, driver's permit card (DL),radio-frequency ID scanner (RFID),biometric fingerprint sensor (FP), Face Recognition (FR), and Global System for Mobile Communication modem (GSM), the system aims to fortify vehicles against unauthorized access. At its core, Arduino serves as the central intelligence, capable of storing and processing authorized driver data such as facial recognition and fingerprint records. When a driver inserts their license into the RFID reader, the system cross-references the information with stored data. If the license is validated, the system proceeds to authenticate the driver's identity through facial recognition and fingerprint scanning. Successful verification enables the ignition system, granting access to the vehicle. However, any discrepancy triggers an immediate SMS alert via the GSM modem to the vehicle owner, while simultaneously disabling the ignition to thwart unauthorized use. Additionally, an alcohol detection module further enhances safety by preventing vehicle ignition if alcohol is detected in the driver's system. This comprehensive approach not only safeguards vehicles from theft but also promotes responsible driving practices, exemplified by timely license renewal reminders and the enforcement of alcohol-free driving. Key Words: Vehicle security system,Arduino integration,Driver's license card (DL), radio-frequency ID scanner (RFID),Fingerprint module (FP) Face Recognition (FR), GSM-enabled mobile communication device, Unauthorized access prevention,Facial recognition,Fingerprint scanning SMS alerts,Alcohol detection module,Responsible driving practices,License renewal reminders,Alcohol-free driving enforcement.

Key Insights from Preflight Planning for Safety Improvement in General Aviation: A Systematic Literature Review

This study highlights the disproportionate number of fatal and non-fatal accidents in general aviation (GA) compared to airline carriers, emphasizing the need to investigate the contributing factors to these incidents. It identifies poor decision-making and a lack of situational awareness as key issues and presents a systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to analyze preflight information used by GA pilots. The findings underscore the significance of operational factors in ensuring a successful flight and suggest modifications to pilot license renewal processes, with an emphasis on the adoption of digital preflight tools. A new theoretical framework based on the operational factors identified is also introduced, which could serve as a foundation for future studies and interventions aimed at enhancing safety in general aviation.

손해사정사제도의 실태분석 및 개선방안에 관한 연구

In modern society, compared to the past, the economic scale has grown, resulting in greater diversity in insurance coverage and an expansion of the market. Consequently, the causes of losses have become more complex. In this context, accurate determination of liability and indemnity, as well as the fair assessment of insurance claims, have become crucial tasks. As a result, the technical expertise and professionalism of claim-adjuster(CA) are continuously evolving. Claim adjustment primarily serves to realize the insured's interests for insurance claimants. It also plays a pivotal role in securing the competitiveness of insurance companies and providing a basis for determining insurance premiums, ultimately preventing ethical misconduct within the insurance industry. Therefore, this study examines the concept and current status of the loss assessment system, highlighting its issues. Specifically, the study explores the existing CA system in South Korea and relevant domestic laws. It also reviews international CA systems to provide insights. The research proposes several improvements to the CA system. Firstly, it suggests enhancing the independence of CA through a detailed delineation of their authority and the establishment of a legal protection framework. Secondly, it advocates for the enhancement of the professionalism of CA through the strengthening of qualification systems and the introduction of continuous education. Notably, it emphasizes the consolidation of loss assessor functions, focusing on strengthening examination subjects and recognition systems, introducing continuous education, and implementing license renewal procedures.

Access to continuous professional development for capacity building among nurses and midwives providing emergency obstetric and neonatal care in Rwanda

BackgroundNurses and midwives are at the forefront of the provision of Emergency Obstetric and Neonatal Care (EmONC) and Continuous Professional Development (CPD) is crucial to provide them with competencies they need to provide quality services. This research aimed to assess uptake and accessibility of midwives and nurses to CPD and determine their knowledge and skills gaps in key competencies of EmONC to inform the CPD programming.MethodsThe study applied a quantitative, cross-sectional, and descriptive research methodology. Using a random selection, forty (40) health facilities (HFs) were selected out of 445 HFs that performed at least 20 deliveries per month from July 1st, 2020 to June 30th, 2021 in Rwanda. Questionnaires were used to collect data on updates of CPD, knowledge on EmONC and delivery methods to accessCPD. Data was analyzed using IBM SPSS statistics 27 software.ResultsNurses and midwives are required by the Rwandan midwifery regulatory body to complete at least 60 CPD credits before license renewal. However, the study findings revealed that most health care providers (HCPs) have not been trained on EmONC after graduation from their formal education. Results indicated that HCPs who had acquired less than 60 CPD credits related to EmONC training were 79.9% overall, 56.3% in hospitals, 82.2% at health centres and 100% at the health post levels. This resulted in skills and knowledge gaps in management of Pre/Eclampsia, Postpartum Hemorrhage and essential newborn care. The most common method to access CPD credits included workshops (43.6%) and online training (34.5%). Majority of HCPs noted that it was difficult to achieve the required CPD credits (57.0%).ConclusionThe findings from this study revealed a low uptake of critical EmONC training by nurses and midwives in the form of CPD. The study suggests a need to integrate EmONC into the health workforce capacity building plan at all levels and to make such training systematic and available in multiple and easily accessible formats.Implication on nursing and midwifery policyFindings will inform the revision of policies and strategies to improve CPD towards accelerating capacity for the reduction of preventable maternal and perinatal deaths as well as reducing maternal disabilities in Rwanda.

Implementation of E-Government in South Jakarta: A Case Study of Digital Services Through The Digital Application of Polri's Traffic Corps

This research examines the implementation of e-government through the Digital Application of the Indonesian National Police Traffic Corps (Korlantas POLRI) in South Jakarta in an effort to improve the quality of public services, particularly in the processing of driving license (Surat Izin Mengemudi or SIM) renewals. This application aims to facilitate the public in renewing SIM cards online without having to visit the SATPAS office. The implementation of this application has provided positive impacts in terms of service efficiency and effectiveness, ease of access, and increased public satisfaction. However, there are challenges such as digital divide and concerns about the security of personal data. Factors influencing the success of implementation include effective communication, smooth and efficient implementation activities, and the disposition or attitude of policy implementers. There are inputs and criticisms from the public regarding the payment system, the length of the renewal process at some SATPAS offices, lack of clear information, and requests to move or cancel applications. Improvement efforts are needed in terms of the payment and online registration systems, increasing the capacity of SATPAS offices, information transparency, and flexibility for users in choosing SATPAS offices. The implementation of this application provides benefits in improving the quality of public services, but there are still challenges that need to be overcome to optimize success and increase public satisfaction.

A Holistic Evaluation of BIM Implementation Barriers in the Indian Construction Industry: Pre- and Post-Adoption Perspectives

ABSTRACT The existing Building Information Modelling (BIM) research does not provide a holistic understanding of pre- and post-adoption barriers to its implementation, especially in developing countries such as India, where BIM adoption lags. First, a total of 32 barriers to BIM implementation were identified after a comprehensive literature review. Second, after discussion with experts, the barriers were classified into 23 pre- and 21 post-adoption barriers. Next, the barriers were ranked based on 218 completed survey responses from professionals working in 125 organizations in the Indian construction industry. Finally, an independent samples t-test was conducted to understand differences in the perceptions of different groups of participants. The top five pre-adoption barriers were (1) high hardware costs, (2) high software costs, (3) low adoption across the supply chain, (4) low market support, and (5) unclear benefit evaluation. In comparison, the top five post-adoption barriers were (1) high ongoing cost (license renewal, training cost, etc.), (2) shortage of skills and expertise, (3) unclear benefit evaluation, (4) client’s lack of understanding, and (5) user resistance. Moreover, clients, contractors and consultants shared different views on very few barriers, which shows that these barriers are prevalent across different types of organizations in the Indian construction industry.

Credit hours and continuing medical education (CME) programmes.

Continuing medical education (CME) credits has been mandated by the National Medical Commission for registered medical practitioners in India as a part of continuing professional development and a minimum of 30 credits in 5 years is required for the renewal of the medical license. Undoubtedly, credit hours for CME attendance is an essential yardstick for professional and career growth, the modus operandi adopted to grant these credit hours needs a serious look. Targeted learning with adequate feedback either with a post CME examination or questionnaire should become the norm and every publication in high impact indexed journal deserve a higher credit point than the rest of the publications.

Westinghouse fluence methodology uncertainty estimates for reactor vessel internals fast neutron exposure evaluation in subsequent license renewal period

The United States Nuclear Regulatory Commission (USNRC) has expressed concerns about the calculated fast neutron fluence exposure uncertainties for the reactor vessel internals (RVI) of light water reactors for extended operation [1, 2]. The current guidance for calculating neutron fluence, Regulatory Guide (RG) 1.190 [3], was developed with a focus on the reactor pressure vessel (RPV) region surrounding the active core, which may not be adequate for the RVI above and below the active core during the license renewal periods, especially the subsequent license renewal (SLR) period. An updated version of ANSI/ANS 19-10 [4] may fill the regulatory guidance gap on neutron fluence determination methodology for RVI but still faces the challenges of lacking RVI fluence measurement benchmark data and analytical uncertainty analysis, which are two cornerstones for qualifying a neutron fluence determination methodology. The Pressurized Water Reactor Owners Group (PWROG) has responded to this regulatory concern and have performed analytical uncertainty analysis and measurement benchmark work to address these two technical challenges for the nuclear power industry.

The Efficiency and Firm Performance Analysis of Nigeria Manufacturing Firms: Application of Stochastic Frontier Analysis Technique

ABSTRACT: Despite several measures adopted by the government to improve the efficiency of the manufacturing firms in Nigeria, the performance of these firms is below expectation. The poor performance of Nigerian manufacturing firms has prompted concern for Nigeria’s economic prospects in the long run. This needs to be addressed because, under this scenario, most development objectives would be difficult to achieve. Therefore, there is a need for Nigerian manufacturing firms to achieve high productivity to improve their performance. This study, therefore, evaluated the level of technical efficiency and examined the determinants of technical inefficiency in Nigerian manufacturing firms. It employed panel data of fifty-five manufacturing firms quoted in the Nigeria Stock Exchange Market from 1999 to 2020. The result from the Stochastic Frontier Analysis technique showed that all inputs (capital, labor, raw materials, cost of energy and other expenses) impacted positively on firms’ output at a 1% significance level. But the impact of raw material is the highest. It was also found that the mean efficiency for Nigerian manufacturing firms is 52.74%. Finally, it was revealed that the age of the firm, total assets and management efficiency are the technical inefficiency determinants in Nigerian manufacturing firms. This implies that the efficiency level of manufacturing firms in Nigeria can be improved by 47.26%. Also, manufacturing output can be enhanced by providing adequate raw materials. Furthermore, the efficiency of manufacturing firms in Nigeria is enabled by the managerial capability and asset size of the firms. The study suggested that government should give tax concessions on the purchase of raw materials (sourced domestically and externally) to encourage availability and use to optimize production. Also, manufacturing firms should encourage skill acquisition programs through various on-the-job training programs for managers and their entire workforce to boost labor productivity and performance. In addition, policies that will encourage good education system should be adopted by the government which will help the nation to produce trained and skilled labor force. Finally, manufacturing firms should mobilize more resources for the procurement, consolidation and expansion of the size of their assets using their undistributed corporate profit. Through its regulatory bodies [such as Federal Ministry of Industries, Trade and Investment, Nigeria Chamber of Commerce and Industry and Small and Medium Enterprises Development Agency of Nigeria (SMEDAN)], government should enforce minimal asset requirements for each sub-sector (industry) as a basis for takeoff and subsequent renewal of licence for the manufacturing firms in Nigeria.

An analysis of the governance of the Japanese teacher license renewal system

This study aims to analyse the development of the teacher license renewal system in Japan since 1980s from a governance viewpoint that considers the renewal system as maintenance of teachers' professional status and function of social trust on the perspective social closure, affected by the socio-political context under neoliberalism. Documents and literature are collected and analysed by content analysis on the governance of teacher certificate. The study findings report that the development and implementation of the renewal system must deal with how the rationality of governance and the governance rule effect the segmentation, exemption objects, class lecture content, transfer of state responsibility to teachers, system integration, and teacher identification.

Exploring LGBTQ+ cultural competency and DEI in continuing education: A cross-sectional review of U.S. pharmacy legislation

BackgroundLesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, or other sexual orientations or gender identities (LGBTQ+) cultural competency training is offered in pharmacy curricula to variable extents. State legislation directly dictates pharmacist training through continuing pharmacy education (CPE) requirements. ObjectivesThis study aimed to identify the U.S. states and the District of Columbia (D.C.) that require CPE or training on topics related to LGBTQ+ cultural competency or topics related to diversity, equity, and inclusion (DEI) in general. In addition, this study quantified and compared each state’s CPE hours required for each renewal period. MethodsThis cross-sectional study retrospectively examined pharmacy legislation on CPE requirements for each of the 50 U.S. states and D.C. Only state legislation that was signed into law and related to pharmacy practice was included. Official websites for each board of pharmacy were identified to locate lawbooks, laws, rules, regulations, and statutes specific to pharmacy practice. Search terms included “lgbt,” “lgbtq,” “cultural,” “cultural competency,” “equity,” “health equity,” “implicit,” and “implicit bias.” Two study investigators independently collected data from March 2023 to April 2023. Data were re-reviewed for accuracy in January 2024. Discrepancies were resolved through discussion until a consensus was reached. The total number of required CPE hours, years for each pharmacist license renewal, required LGBTQ+ cultural competency CPE hours, and required DEI-focused CPE hours were described using descriptive statistics. ResultsA total of 44 of 51 states and D.C. required 30 CPE hours for each 2-year renewal cycle or 15 CPE hours for each 1-year renewal cycle. California and D.C. had LGBTQ+ cultural competency CPE requirements of 1 CPE hour or 2 CPE hours per cycle, respectively. Five additional states, Illinois, Maryland, Michigan, Oregon, and Washington, required training or CPE on topics related to DEI as a whole. ConclusionFew U.S. states require CPE on LGBTQ+ cultural competency. This study highlights the need for standardized pharmacist training in LGBTQ+ health care.

Assessment of water level fluctuation impacts along River Nile, Egypt

ABSTRACT This paper aims to develop a computational model to assess and evaluate the annual water level fluctuation (WLF) impacts and their trends along any open channel (river, canal or lake) and provide reliable information that may help handle their implications. The impacts are related to water recession, flood plain areas, uncovered river bars and islands, locations of navigation bottle necks, and dredging works. The model is developed using Excel Spreadsheet VBA Coding. It computes the horizontal and inclined recession distances that govern water in take construction. It also computes the uncovered flood plain areas along the river reach to avoid encroachments and human interventions. In addition, it identifies the number of bar sand islands that emerge at low water levels to protect them against infringements. It also determines the locations of navigation bottle necks and computes the dredge volumes required. It can handle long river reaches quickly. Moreover, it is open-accessed where no hard locks or license renewals are required. It is run on Microsoft Excel which is an available and familiar environment to engineers. Therefore, the model can be a quick and powerful tool to support the decision-making process for projects related to such impacts, especially at the prefeasibility study stages. Reach '1' of River Nile in Egypt was taken as a case study to apply the model and show its capabilities in assessing the WLF impacts. This could help compute and analyze the size of the impacts and conceive their trends. Finally, the model could provide information about the impacts in concrete figures which can support decision making in coping properly with the impacts.