Management Patterns Research Articles

Unveiling Economic Synchrony: Analyzing Lag Dynamics between GDP Growth and Construction Activity in Poland and Other EU Countries

This study examines the dynamic relationship between the business cycle and the construction sector activity in 27 EU countries, focusing on Poland. Using the cross-correlation function (CCF) and a set of economic- and construction-related variables, including GDP growth, construction production, building permits, and construction operating time by backlog, quarterly data from 2000Q1 to 2023Q2 (94 quarters in total) are analyzed. Beyond the CCF analysis, causality is also examined using Toda–Yamamoto tests to explore the nuanced temporal relationships between GDP growth and construction activity proxies. The research uncovers synchronized positive lag max results for construction production, suggesting a harmonized response to broader economic changes, especially within 9 to 11 quarters. In contrast, building permits and construction time by backlog show divergent positive lag max values, suggesting the need for tailored, localized strategies. Negative lag max values emphasize the anticipatory role of the construction sector as an early indicator of economic change. Overcoming methodological challenges, this study provides insights critical for policymakers and researchers, promoting a nuanced understanding of economic synchrony and guiding informed strategies for sustainable development. Future recommendations include refining localized strategies based on lag patterns for optimal economic management.

KONSERVASI SUMBER AIR DAN WISATA EDUKASI DI DESA NGENEP KECAMATAN KARANGPLOSO KABUPATEN MALANG

Ngenep Village, Karangploso District, Malang Regency has the potential of natural resources in the form of a large enough water source. This water source is named Sumber Nyolo, Sumber Nyolo is used by society for daily needs and it’s used for irrigating agricultural land, besides Ngenep Village there are four other villages from Singosari District that use it. In addition to use for daily needs and irrigation, currently the Sumber Nyolo area is starting to be developed into a tourist destination, tourism management is carried out by community groups who are members of the Sumber Nyolo Pokdarwis (Tourism Cognizant Group). The management pattern carried out by Pokdarwis is still relatively simple, besides that the quality varies. As a result of this, it affects the quality of natural resources and the cleanliness of the area. Based on the various explanations that have been explained, the problems in the Sumbernyolo area, Ngenep Village, Karangploso District, Malang Regency that urgently need a solution are as follows: (1) How to develop active participation of the surrounding community and Pokdarwis Sumbernyolo towards the development of educational tourism and conservation of the Sumbernyolo area? (2) How to prevent forest quality degradation? (3) How to utilize water resources through a wise use pattern? (4) How to organize and develop conservation areas and educational tourism in Sumbernyolo? The method of activities carried out is through an inventory of tourism potential, then a strategy for developing tourism destination areas (DTW) is carried out. For further socialization to the main tourism actors, namely Pokdarwis and the surrounding community who are involved about the direction of development of Sumbernyolo tourism. After the socialization, it was followed by improving tourism infrastructure and supporting elements such as empowering the surrounding community. The process will always be monitored and overall periodically. The results of the activities carried out consist of two aspects, namely the conservation of water sources and forests and the development of educational tourism facilities. The conclusion of this activity is that by carrying out this service activity, a direction for developing Sumber Nyolo tourism is formed towards conservation tourism and educational tourism areas.

Assessment of Financial Performance of Siti Fatimah Hospital, South Sumatra Province, In The Application of The Regional Public Service Agency (PPK-Blud) Financial Management Pattern

Regional General Hospital (RSUD) is a Government-Owned Hospital tasked with providing health services for the community. The purpose of this study is to measure the financial performance of the Siti Fatimah Regional General Hospital (RSUD) of South Sumatra Province; since 2018, it has become a Regional Public Service Agency (BLUD). Data collection techniques are carried out by interview, observation and documentation methods. The data analysis method uses Financial Ratios and BLU Financial Management Compliance by the Regulation of the Director General of Treasury Number PER-22 / PB / 2020. The results of this study, from 2018 to 2022, when viewed from Financial Ratios, show that several ratios have not received optimal scores. Several indicators have not received an optimal score from the BLU Financial Management Compliance level. When viewed as a whole from the assessment of financial aspect performance, Siti Fatimah Hospital of South Sumatra Province has received a GOOD predicate. However, it has not achieved the most optimal score.

Real-world survival outcomes and treatment patterns in patients (pts) with unresectable hepatocellular carcinoma (uHCC): Results from the OREIOS study.

449 Background: Recent advances in systemic therapies have revolutionized the management of HCC. However, there is limited real-world data on treatment patterns and survival outcomes in pts with uHCC. OREIOS (NCT05239507) study determined the clinical characteristics, management patterns and survival outcomes in pts with uHCC from 12 countries across Asia, Latin America, and Middle East and Africa. Methods: This non-interventional, retrospective study included pts with Barcelona Clinic Liver Cancer (BCLC) stage B or C unresectable or advanced/metastatic HCC at index date (date of diagnosis), diagnosed between January 2017 and December 2019. We present the clinicodemographic characteristics, treatment patterns, median overall survival (mOS), landmark survival (12 and 24 months), and median progression-free survival (mPFS). Results: A total of 1115 pts (median [range] age: 63 [18.0-97.0] yrs) were assessed; 83.2% (928/1115) were males, 49.1% (422/859) were current or ex-smokers, 21.4% (122/571) consumed alcohol. Most common etiologies were hepatitis B (48.9% [529/1082]), hepatitis C (23.1% [250/1082]) and alcoholic liver disease (6.6% [72/1082]). At index date, 22.3% (249/1115) and 77.7% (866/1115) presented with BCLC stage B and C, respectively with main portal vein invasion in 23.5% (262/1114), >50% liver involvement in 23.1% (250/1081) and extrahepatic metastases in 48.5% (541/1115). After index date, treatment modalities included systemic therapy (88.2% [992/1112] (including sorafenib [77.5%], nivolumab [21.3%], lenvatinib [19.8%], regorafenib [15.6%]), transarterial chemoembolization (TACE) (20.8% [232/1115]), and surgery (2.6% [29/1115]). The mPFS was 6.6 (95% CI 6.0, 7.2) months and mOS was 13.1 (95% CI 11.6, 14.2) months. Conclusions: Our study provides real-world data on treatment patterns and reports poor prognosis with pts reaching a mOS of ∼13 months. With novel agents and combination therapies being approved for uHCC, integrating them in routine care is important to improve survival. Alongside, further real-world studies are warranted for evaluating the change in treatment patterns and prognosis. Clinical trial information: NCT05239507 . [Table: see text]

Patterns of presentation and delivery of care of appendiceal neoplasms in the largest municipal health care delivery system in the United States.

14 Background: Appendiceal neoplasms (AN) are rare tumors with a broad spectrum of referral and treatment patterns. NYC Health+Hospital (HHC) is the largest municipal health care system in the United States. Here, we study patterns of presentation and management of AN in this safety-net setting. Methods: We identified 92 patients in HHC with AN between 01/01/2017 to 07/01/2023. Statistical analyses were performed in Python. Results: There were 38 (41.3%) mucinous neoplasms, 24 (26.1%) adenocarcinomas, 23 (25.0%) neuroendocrine, and 7 (7.6%) ex-goblet cell adenocarcinomas. 16 cases of pseudomyxoma peritonei were identified. The median age at diagnosis was 55 (IQR: 45-65). 49% were Hispanic, and African Americans were the largest racial block (28%). 50% of cases presented as appendicitis. Appendectomy and a second surgical intervention were more common in this group (p<0.001 and p=0.044, respectively). Other surgical interventions included colon resections and cytoreduction ± Hyperthermic intraperitoneal chemotherapy. Among the patients with mucinous neoplasm or adenocarcinoma, 35 had multidisciplinary tumor board discussion (15 mucinous neoplasm and 20 adenocarcinomas). The median follow-up period was 22.0 months (95% CI: 11.5-30.7 months). Surveillance modalities included CT (75%), CEA (74%), and colonoscopy (35%). 85% remained within HHC during treatment. 16 patients were planned to have chemotherapy, including 9 pseudomyxoma peritonei cases. 5 patients did not follow through, and the other cases had a median of 10 cycles. The following adjuvant chemotherapy regimens were employed: 50% FOLFOX, 20% FOLFIRI, 20% XELODA, and 10% CapeOX and FOLFIRI. There were 2 cancer-related deaths (pseudomyxomas). Excluding pseudomyxomas, none had evidence of disease at the last follow-up. Conclusions: Minorities and immigrants constitute the majority of the population of HHC. 50% of AN presented as appendicitis emphasizing the need for a robust system to identify these cases. Despite challenges encountered in providing long-term oncological care, HHC has treated and provided vigorous follow-up for this underserved population. [Table: see text]

Pola Manejemen Kelas Guru Sekolah Dasar Di Kota Surabaya Terhadap Persoalan Motivasi Belajar Siswa Rendah

Learning in elementary schools involves various challenges and problems, especially those related to students' developmental characteristics. Teachers are expected to be able to design and implement learning that is appropriate to students' cognitive, social and emotional development. Students' learning motivation in elementary schools can be a serious obstacle, affecting the achievement of learning outcomes. Classroom management is considered the key to creating an effective learning atmosphere and motivating students. This research aims to determine the classroom management patterns implemented by elementary school teachers in the city of Surabaya regarding the problem of low student learning motivation. This research is qualitative research with a multi case study type, using the Explanatory Survey method. The informants consisted of 23 elementary school teachers in the city of Surabaya, selected using a cluster random sampling technique. Data collection was carried out through interviews, and data analysis was carried out descriptively qualitatively. The research results show that the main obstacle in learning is students' passivity and noise which is triggered by low learning motivation. Some teachers apply a Student-Centered Learning (SCL) approach to overcome this problem, placing students as active subjects. Classroom rules, learning contracts, and inspirational stories are considered effective classroom management strategies. Teachers also provide interactive feedback and emphasize an emotional approach to increase students' sensitivity.

Investigation of E-Business Motivation Among Batik SMEs in Indonesia

Purpose: This research explores how to establish a conceptual framework for an empirical model of e-business motivation in small organizations, while most e-business studies focus on large companies. To explain SMEs' tactics and features, notably family businesses' increased e-business motivation. Theoretical Framework: Technological developments have an impact on changing business management patterns, many business opportunities can be captured by companies including small and medium enterprises (SMEs) to be able to expand the market and increase sales. Design/Methodology/Approach: ANOVA analysis was used for quantitative analysis. This research took a sample of 122 Batik SMEs from the Batik center villages of Klaten, Jarum, Beluk, Banyuripan, and Kebon Regencies. The sampling method was purposive, namely by using batik SMEs that have used social media or websites to carry out promotions and sales. Findings: SMEs in the innovator category were more driven than reactors. Innovative companies succeeded in internet marketing, communication, and profit. However, the two groups employed e-business for study similarly. This shows that innovators and reactor companies have not fully adopted the e-business market or industry surveys. Implications of Research: This research shows that the success of e-business practices, especially electronic promotion and selling, will increase with strategic orientation that strives for innovation, as market coverage expands, and business duration increases. Originality/Value: E-business strategies and competencies in small businesses are infrequently investigated, whereas major enterprises are extensively studied. demonstrates that SMEs have distinct firm structures and HR development programs than major companies, hence their e-business practices will differ.

Investigation of E-Business Motivation Among Batik SMEs in Indonesia

Purpose: This research explores how to establish a conceptual framework for an empirical model of e-business motivation in small organizations, while most e-business studies focus on large companies. To explain SMEs' tactics and features, notably family businesses' increased e-business motivation. Theoretical Framework: Technological developments have an impact on changing business management patterns, many business opportunities can be captured by companies including small and medium enterprises (SMEs) to be able to expand the market and increase sales. Design/Methodology/Approach: ANOVA analysis was used for quantitative analysis. This research took a sample of 122 Batik SMEs from the Batik center villages of Klaten, Jarum, Beluk, Banyuripan, and Kebon Regencies. The sampling method was purposive, namely by using batik SMEs that have used social media or websites to carry out promotions and sales. Findings: SMEs in the innovator category were more driven than reactors. Innovative companies succeeded in internet marketing, communication, and profit. However, the two groups employed e-business for study similarly. This shows that innovators and reactor companies have not fully adopted the e-business market or industry surveys. Implications of Research: This research shows that the success of e-business practices, especially electronic promotion and selling, will increase with strategic orientation that strives for innovation, as market coverage expands, and business duration increases. Originality/Value: E-business strategies and competencies in small businesses are infrequently investigated, whereas major enterprises are extensively studied. demonstrates that SMEs have distinct firm structures and HR development programs than major companies, hence their e-business practices will differ.

Locals’ Claims of Rights and Access to Forest Resources in Three Forest Management Regimes in Gunungkidul Regency, Yogyakarta

One of state forest areas managed by three management regimes is Bunder forest area, Gunungkidul, Yogyakarta. Three management regimes are the production forest of KPH Yogyakarta, the conservation forest of Tahura, and the educational forest of KHDTK Wanagama I. The differences of management regimes are thought to affect the actual interaction pattern of villagers with the forest. This research aims to compare the actual rights and access of villagers to Bunder forest area in three management regimes in the hope of finding more effective forest management patterns. This research used a qualitative approach through the case study method of the interaction villagers of Bunder, Banaran, Ngleri, and Gading villages with the surrounding forests. The results show that forest management regimes affects the way villagers can access the forests. The aggregate value of the actual rights received by the villagers to the production forest of KPH Yogyakarta is higher than the educational forest of KHDTK Wanagama I. The lowest is management regimes in conservation forest of Tahura. Based on the access mechanisms that empower villagers, the educational forest regime of KHDTK Wanagama I is higher than the production forest regime of KPH Yogyakarta and the conservation forest regime of Tahura. This research recommends defining rights and access to increase certainty about the benefits of forest resources.

Bioactive Components, Applications, Extractions, and Health Benefits of Winery By-Products from a Circular Bioeconomy Perspective: A Review.

Significant waste streams produced during winemaking include winery by-products such as pomace, skins, leaves, stems, lees, and seeds. These waste by-products were frequently disposed of in the past, causing resource waste and environmental issues. However, interest has risen in valorizing vineyard by-products to tap into their latent potential and turn them into high-value products. Wine industry by-products serve as a potential economic interest, given that they are typically significant natural bioactive sources that may exhibit significant biological properties related to human wellness and health. This review emphasizes the significance of winery by-product valorization as a sustainable management resource and waste management method. The novelty of this review lies in its comprehensive analysis of the potential of winery by-products as a source of bioactive compounds, extraction techniques, health benefits, and applications in various sectors. Chemical components in winery by-products include bioactive substances, antioxidants, dietary fibers, organic acids, and proteins, all of which have important industrial and therapeutic applications. The bioactives from winery by-products act as antioxidant, antidiabetic, and anticancer agents that have proven potential health-promoting effects. Wineries can switch from a linear waste management pattern to a more sustainable and practical method by adopting a circular bioeconomy strategy. Consequently, the recovery of bioactive compounds that function as antioxidants and health-promoting agents could promote various industries concomitant within the circular economy.

Methodology for regional industrial complex management: Architecture of an agent-based model

Industry is the backbone of the economy of developed countries and individual regions. To optimize management processes in such a complex and multi-level sector, specific economic-mathematical models and practical tools have to be developed. The paper discusses the optimal architecture of the regional industrial complex management model on a modern theoretical-methodological and instrumental (program) basis. The classical management theory, optimization theory and game theory constitute the methodology of this study. Among the research methods applied are agent-based and minimax approaches. We substantiate the use of agent-based modelling to simulate administering the regional industrial complex. The paper presents a three-tiered management architecture consisting of federal, regional and company level authorities (united by type of activity). For each level, control agents are identified and a set of indicators formed, which cover the structure of the phase vector, including its attributes, key parameters, control actions used, risks, a model of the parameters’ dynamics, and a model of the data possessed by the object. We build a hierarchical structure of administration and information relationships in the model and, based on the minimax approach, create an algorithm of agents’ efforts to select optimal control actions. The proposed architecture will allow forming a flexible toolkit for assessing industrial development scenarios and producing the best step-by-step management pattern of the regional industrial complex.

P14 Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam Real-world Analysis (SPECTRA): results from a multinational, multicentre observational study

Abstract Background Ceftolozane/tazobactam (C/T) has demonstrated efficacy to treat complicated intra-abdominal infections (cIAI), complicated urinary tract infections (cUTI) and hospital acquired bacterial and ventilator-associated bacterial pneumonia. However, physicians, providers, and other stakeholders including payers want broader real-world evidence to inform clinical decisions and optimize healthcare resource use. Methods SPECTRA is a multinational, multicentre, retrospective, inpatient, observational study of patients treated with C/T in Australia, Austria, Germany, Italy, Mexico, Spain and the UK. Adult inpatients treated with ≥48 h of C/T were included. Demographics, clinical characteristics, treatment management patterns, and outcomes were analysed. Results There were 687 patients from 38 participating hospitals in 7 countries. The average age was 57.6 years (SD ±17.3), and most were male (456, 66.4%). The majority had at least one comorbidity (563, 82.0%), with the most common being heart disease (208, 30.3%), immunocompromised state (207, 30.1%) and chronic pulmonary disease (195, 28.4%). The most common indications were pneumonia (204, 29.7%), sepsis (147, 21.4%) and cIAI (106, 15.4%); 162 (23.6%) had multiple sites of infection and 245 (35.7%) were polymicrobial infections. Median C/T treatment was 12.0 days (IQR 11.0). Half of the patients were admitted to the ICU (343, 49.9%), 43.4% of which was related to the infection. Clinical success was 66.1%. All-cause in-hospital mortality was 22.0% with 8.7% being infection related. The 30 day all-cause readmission was 9.8% and 4.7% were infection related. Conclusions C/T was used to treat infections among critically ill patients and for multi-source, polymicrobial infections. Despite the complexity of the patients in this real-world analysis, most C/T patients had beneficial outcomes that are similar to results of controlled clinical trials.

Patterns of knee osteoarthritis management in general practice: a retrospective cohort study using electronic health records

ObjectiveThis study determined patterns of knee osteoarthritis (OA) management by general practitioners (GPs) using routine healthcare data from Dutch general practices from 2011 to 2019.DesignA retrospective cohort study was conducted using the Integrated Primary Care Information database between 2011 and 2019. Electronic health records (EHRs) of n = 750 randomly selected knee OA patients (with either codified or narrative diagnosis) were reviewed against eligibility criteria and n = 503 patients were included. Recorded information was extracted on GPs’ management from six months before to three years after diagnosis and patterns of management were analysed.ResultsAn X-ray referral was the most widely recorded management modality (63.2%). The next most widely recorded management modalities were a referral to secondary care (56.1%) and medication prescription or advice (48.3%). Records of recommendation of/referral to other primary care practitioners (e.g. physiotherapists) were found in only one third of the patients. Advice to lose weight was least common (1.2%). Records of medication prescriptions or recommendation of/referral to other primary care practitioners were found more frequently in patients with an X-ray referral compared to patients without, while records of secondary care referrals were found less frequently. Records of an X-ray referral were often found in narratively diagnosed knee OA patients before GPs recorded a code for knee OA in their EHR.ConclusionThese findings emphasize the importance of better implementing non-surgical management of knee OA in general practice and on initiatives for reducing the overuse of X-rays for diagnosing knee OA in general practice.

Model of Educational Leadership Management in Boarding Schools

Islamic boarding schools have a wealth of knowledge that can be researched and analyzed from various scientific aspects, so research on Islamic boarding schools will be available. This study will focus on the management pattern of pesantren leadership education by choosing the largest pesantren in the country, namely the Darussalam Gontor Modern Islamic Boarding School. A qualitative method with a case study approach. Data were obtained from key informants, Islamic boarding school documents and books, journals and articles as support related to the management of leadership education in the era of globalization. Data analysis in this study used content analysis techniques. The results of the study found that the management of leadership education in the form of regeneration in the style of the Gontor Islamic Boarding School was classified into six: briefing, training, assignment, habituation, control and role modelling. The revival of leadership values at the Gontor Islamic Boarding School includes education of ibrah, habituation, mauidzah, discipline, independence and exemplary. The pattern of leadership in Darussalam Gontor Islamic Boarding School is collegial (Trimurti). The administration of the Trimurti pesantren Darussalam Gontor became the central figure of the pesantren in the leadership of three kiai. With this collective leadership model, the Gontor Islamic Boarding School will eventually become a modern institution whose survival does not depend on a single kiai as the supreme leader. Thus, Islamic boarding schools are expected to be able to foster and produce Islamic human resources.

Clinical Manifestations and Treatment Outcomes of Brucella Endocarditis: A Retrospective Cohort Study at a Tertiary Cardiac Centre in Bengaluru, Karnataka, India

Introduction: Brucella is a rare cause of Infective Endocarditis (IE), requiring prompt early recognition and treatment to prevent life-threatening complications. Diagnosis is often missed or delayed, leading to an increase in cardiac morbidity and mortality. Aim: To analyse the clinical profile, laboratory parameters, cardiac manifestations, management patterns, and outcomes of Brucella endocarditis. Materials and Methods: A retrospective cohort study was conducted at the Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangaluru, Karnataka, India on patients with blood culture-confirmed Brucella endocarditis, diagnosed using modified Duke’s criteria between January 2010 and December 2021. The present study evaluated the clinical presentation, treatment modalities, and outcomes. Descriptive statistical analyses were performed. Results: A total of 34 cases were identified during the study period. The mean age of the patients was 35.6±14 years (age range: 15-66 years), with 82.4% males and 17.6% females. Underlying valvular heart disease was present in 82.4% of the patients, while 17.6% had no pre-existing valvular heart disease. Both aortic and mitral valves were involved with equal frequency. All patients presented with fever. Most patients had a normal leukocyte count (61.8%). Thrombocytopenia (32.3%) and pancytopenia (17.6%) were also observed. Large vegetations (>1 cm) were seen in 38.2% of patients, and complications related to IE were observed in 35.2%. The majority of patients (82.4%) were managed medically alone in the acute phase. The antibiotic regimen of doxycycline with rifampicin combined with intravenous gentamicin was used in the majority of the patients. The observed mortality rate was 17.6%. Conclusion: Brucella endocarditis can present with thrombocytopenia/pancytopenia along with normal or reduced leukocyte count. The addition of intravenous gentamicin to oral therapy may reduce relapse rates.

Using the Saga design pattern for transaction management in a microservice architecture

The use of microservice architecture in software development, in which each service is a self-sufficient participant with its own area of responsibility, its own data store, set of technologies, and work environment, is challenging in the context of transactions in a distributed service mode. After all, from the point of view of reliability and integrity of the system, it is extremely important to ensure data consistency, which implies compliance with defined restrictions and rules, absence of contradictions and consistency of data between system components. The architecture built on microservice interaction provides capabilities for decomposition of complex tasks, operational implementation of new functionality, isolation of critical components and scaling of individual software components. As a rule, the microservice architecture implements the principle «Database per service» — an approach according to which each microservice uses its own database, instead of a single shared database, as is usually implemented in a monolithic architecture. To ensure data consistency, the SAGA design pattern can be used, which provides a set of instructions for the correct management of transactions in a distributed architecture. To avoid the use of distributed transactions, it is recommended to use the SAGA design pattern, which allows for global data consistency through sets of local and compensating transactions. The template is fault-tolerant and ensures system reliability and integrity.

Use of Knowledge Translation Action Framework to Improve Physical Therapy Rehabilitation Outcomes in Concussion Management.

Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework. Pretraining and posttraining intervention study. Rehabilitation professionals were electronically surveyed pre-post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre-post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know-do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28). Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre-post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001). Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.

Direct oral anticoagulant use in hospitalized patients with atrial fibrillation across body mass index categories: design and rationale for a retrospective cohort study.

Atrial fibrillation (AF) and obesity are common conditions globally; yet, there remains suboptimal pharmacological management contributing to high rates of hospitalization in patients with AF. The altered pathophysiology of both obese and underweight individuals may influence the pharmacology of medications, including those used to manage AF. This, in turn, increases the risk of adverse events and impacts patient risk for stroke and rehospitalization. Despite the well-established complications of obesity, research investigating the relationship between obesity and AF is scant. The primary aim of this study is to describe cardiovascular-related hospitalization in AF patients according to BMI categories. A secondary aim is to describe anticoagulant and antiarrhythmic prescribing practice patterns in patients with AF, according to the BMI category. A retrospective, exploratory descriptive observational cohort study, using routinely collected electronic medical record data from five public hospitals within a single health district, with a population dominantly that is culturally and linguistically diverse, and has a low socioeconomic status. Data extraction will include a 24-month period (January 2017 to December 2018) with a 12-month follow-up. All adult (⩾18 years) patients at discharge diagnosed with AF, prescribed any oral anticoagulant and/or oral rate/rhythm control agent, will be eligible for inclusion. Ethics approval from the health district and the University of Wollongong has been granted. Findings will seek to demonstrate associations between management strategies and patient outcomes, as well as describe patterns of acute care management from prescribers. These data will be used to inform and generate hypotheses for large-scale studies examining the impact of body weight on anticoagulation prescribing at national and global scales.

Patient and Community Health Worker (CHW) Perspectives on a CHW-delivered Nutrition Intervention for Low-Income Adults with Hypertension: A Qualitative Study.

Adults with food insecurity (FI) face barriers to hypertension management, including difficulty adhering to diet recommendations. Few community health worker (CHW) interventions focus on diet to improve blood pressure. This qualitative study elicited patient and CHW perspectives on healthy eating and a future CHW nutrition intervention for patients with hypertension. Twenty-five patients with hypertension and FI and 5 CHWs participating in a hypertension health coaching program from 5 Boston-area health centers participated in semi-structured interviews from July to September 2023. Interviews were audio recorded, transcribed, and analyzed using the Framework Method. Themes included: 1) Variable patient knowledge about dietary patterns for hypertension management and low confidence in interpreting nutrition labels; 2) Culture influenced healthy food perception; and 3) Barriers to healthy eating included cost, limited cooking abilities/supplies, and competing demands. Patients and CHWs favored simple nutrition education materials (e.g., traffic light nutrition ranking, healthy meals on a budget). Patients had mixed opinions about CHW-accompanied supermarket visits. This study identified culture, knowledge gaps, and budget constraints as factors influencing diet among patients with hypertension and FI. A CHW-delivered intervention could include simplified nutrition education, strategies for healthy eating on a budget, and linkage to community-based food programs.

Earnings Management in Business Groups during the SARS-CoV-2 Pandemic

Abstract This paper aims to assess the influence of the SARS-CoV-2 pandemic on the accrual-based earnings management patterns in non-financial business groups in the Warsaw Stock Exchange (WSE). This study contributes to the existing literature by considering earnings manipulation behaviours in assessing the reporting data quality, both in consolidated financial statements of business groups and individual financial statements of parent undertakings. The research methods are based on the Modified Jones Model with the simultaneous separation of individual subcategories of accruals via cross-sectional analysis and time-series data approach (separately for each business group). Empirical findings supported the presumption that earnings manipulation schemes in the SARS-CoV-2 transitional (2020) and crisis (2021) periods differed statistically compared to the previous 2019 and 2020 years, respectively. Moreover, this article proved that the company‘s potential financial distress could imply accrual-based earnings management behaviours and moderate the association between the SARS-CoV-2 pandemic and earnings manipulations activities. Finally, the obtained results confirmed that although business groups have an expanded set of balance sheet policy instruments, the quality of earnings reported in the individual financial statements of parent undertakings and the consolidated financial statements of business groups were similar during the SARS-CoV-2 pandemic.