Management Strategy Evaluation Research Articles

HUMAN RESOURCE MANAGEMENT STRATEGIES: ANALYSIS AND EVALUATION

In this article, based on the latest literature sources, such an important issue of management theory and practice as the analysis and evaluation of human resource management strategies is investigated. The main stages of the human resource management strategy analysis process that a company should go through to determine the compliance of the strategy with the expected results are considered: analysis, diagnosis, generalisation and recommendations, drawing up an action plan.,resource planning, costs and benefits. Two main human resource management strategies are presented: a general strategy, such as improving the quality of job performance, and a specific strategy dealing with various aspects of managing employees' skills and abilities: training, rewards, increasing motivation. Human resource management strategies such as: commitment-based, collaborative, paternalistic and traditional are analysed and evaluated.

ANALYSIS OF MANAGEMENT STRATEGIES FOR EDUCATIONAL IMPROVEMENT (STUDY ON PRIVATE SCHOOLS IN THAILAND)

General Background: The efficacy of management strategies in enhancing educational outcomes has become increasingly critical, especially in the context of private schools. Specific Background: In Thailand, private schools face unique challenges that necessitate innovative approaches to curriculum development and educational quality. Knowledge Gap: Existing literature reveals limited empirical studies on the impact of curriculum innovation, technology integration, and business partnerships on private school performance in Thailand. Aims: This research aims to evaluate management strategies that improve performance in Thai private schools, with a specific focus on curriculum development and its role in elevating educational standards. Results: Utilizing a mixed-methods approach, including literature reviews, case studies, and cross-sectional primary data collected through observations and interviews with schools in Southern Thailand, the study identifies that relevant, innovative, and competency-based curricula are pivotal in enhancing educational quality. The integration of technology and establishment of business partnerships are also critical in preparing students for future challenges. Novelty: This study contributes to the existing body of knowledge by providing empirical evidence on the effectiveness of these strategies in the Thai private school sector and by evaluating their impact through direct international community service initiatives. Implications: The findings suggest that sustainable and responsive curriculum development is essential for improving the competitiveness of private schools in Thailand, offering valuable insights for educational policy-makers and school administrators aiming to foster long-term educational improvements.

Outcomes of infants with birthweights less than 501 g compared to infants weighing 501-750 g at a center utilizing first intention high frequency jet ventilation.

Data on clinical outcomes of infants with birthweights less than 501 g (ELBW<501) are limited. To evaluate management strategies and clinical outcomes of ELBW<501infants compared to infants weighing 501-750 g (ELBW501-750). A retrospective study of all ELBW<501 and ELBW501-750 infants born between 2012 and 2022 at a center utilizing first intention high frequency jet ventilation was performed. Patient characteristics, clinical and outcome data were compared between the two groups. A total of 358 infants (92 ELBW<501 infants and 266 ELBW501-750) were included. The survival rate for the ELBW<501 group was 60.9% compared to 86.5% for ELBW501-750. ELBW<501 infants required more frequent use of 2.0 mm endotracheal tubes, required higher FiO2 and longer duration of mechanical ventilation. Compared to ELBW501-750 group, the ELBW<501 group were more likely to be SGA (68.2% vs. 16.5%) and more premature (23.2 vs. 24.3 weeks) with lower survival, longer length of stay, higher incidence of ROP and lower weight at discharge but comparable rates of IVH, grade 3 BPD, discharged on supplemental oxygen, and tracheostomy. ELBW<501 infants are at risk for significant morbidity and mortality. However, with specialized obstetric and neonatal care, survival rates of 60% are possible with respiratory outcomes comparable to ELBW501-750 infants. However, the increased risk of severe ROP for ELBW<501 requiring either surgical or medical intervention is concerning and warrants optimal surveillance.

Assessment of meteorological drought impacts on rainfed agriculture using remote sensing-derived biomass productivity.

Assessing drought impacts is necessary for pursuing sustainable development goals relevant to food security and land degradation. Data availability is a major restriction and remote sensing has been promoted for this purpose. Version 3 of WaPOR has been released in 2023, which provides global coverage of remote sensing-derived water productivity indicators and could allow improved analysis of drought impacts, but validation is still needed. This study explores the utility of remote sensing-derived productivity data from WaPOR as a proxy indicator for agricultural drought impacts. The analysis utilized (1) production surveys, (2) meteorological measurements for drought analysis, and (3) remote sensing-derived gross and net biomass water productivities (GBWP & NBWP) and total biomass production (TBP). All layers were analyzed against the Standardized Precipitation and Standardized Precipitation Evapotranspiration Indices (SPI and SPEI) over drought-vulnerable locations in Irbid and Madaba governorates in Jordan. Strong and significant correlations (R2 0.5-0.8, P < 0.05) were obtained between drought intensities and GBWP and NBWP layers, particularly in the May-Sep periods. These correlations were higher than previously tested remotely sensed indicators for agricultural drought impacts. Water productivity and biomass production averages were lower during drier periods and higher during wet periods, but pairwise testing did not reveal significant differences. There is sufficient evidence that WaPOR data demonstrates behavior that reflects agricultural response to drought, and further assessment in other agroclimatic zones is recommended. This could potentially allow for enhanced evaluation of management strategies, decision support, and policy recommendations for drought mitigation.

Evaluation of chemical weed management strategies for enhanced yield and profitability of Mentha crops in Barabanki district of Uttar Pradesh

Evaluation of chemical weed management strategies for enhanced yield and profitability of Mentha crops in Barabanki district of Uttar Pradesh

Management of spinal trauma in pregnant patients: A systematic review of the literature.

Despite the high incidence of spine trauma globally, traumatic spinal cord injury (tSCI) during pregnancy is considered a rare medical emergency. The literature on acute management of these patients is sparse compared with that of mothers with preexisting tSCI. This systematic review aims to evaluate management strategies for tSCI during pregnancy in improving neurologic, obstetric, and neonatal outcomes. A systematic review of PubMed/MEDLINE was performed without language restriction from inception until November 2, 2023 for patients who acquired tSCI during pregnancy. Excluded articles described postpartum trauma, trauma before pregnancy, or SCI of nontraumatic etiology such as neoplastic, vascular, hemorrhagic, or ischemic origin. Primary outcomes investigated were maternal American Spinal Injury Association (ASIA) grade, pregnancy termination, cesarean delivery, prematurity, and neonatal adverse events. Data from 73 patients were extracted from 43 articles from 1955 to 2023. The mothers' median age was 24 years (interquartile range, 23-30 years), and the average gestational age at the time of injury was 21.1 ± 7.7 weeks. The thoracic spine was the most common segment affected (41.1%) and had the greatest proportion of complete tSCI (46.6%). Furthermore, ASIA score improvement was observed in 17 patients with 3 patients experiencing a 2-score improvement and 1 patient experiencing a 3-score improvement. Among these patients, 86% of ASIA B and 100% of ASIA C patients showed neurologic improvement, compared to only 17% of ASIA A patients. Surgically managed patients had a lower rate of neonatal adverse events than conservatively managed patients (11% vs. 34%). Acute tSCI requires a coordinated effort between a multidisciplinary team with careful consideration. While maternal neurologic improvement was observed more often following a better ASIA grade on presentation, the presence of neonatal adverse events was less common in patients treated with surgery than in patients who were managed conservatively. Systematic Review; Level IV.

Performance of length limits to sustain a data- and capacity-limited fishery

Length limit regulations are widely recommended to sustain fish biomass and fishery yields, particularly for data- and capacity-limited fisheries. However, previous findings were generally derived from equilibrium conditions, used hypothetical fisheries, and/or did not explicitly quantify the performance of length limits under a combination of implementation levels, increasing fishing effort, and discard mortality. Here, we apply the management strategy evaluation (MSE) framework to test the performance of three length-limit management procedures (MPs)—maturity and high maturity length limits (i.e., minimum length limits set at and above the length at maturity, respectively) and slot length limit (i.e., excludes both immature and very large fish from retention)—in Iran's largely unregulated, data- and capacity-limited kingfish fishery. We subject these MPs to different conditions, including strong and weak implementations, discard mortality, and an expansion in future fishing efforts, and quantify their overall performance in terms of fishing mortality, biomass, and yield. Our results show that strong implementation of length limits results in the largest gains: the lowest future long-term fishing mortality and the highest biomass and yields relative to the maximum sustainable yield (MSY) level. When illegal-sized fish are selected but discarded with high discard mortality under strong implementation, or retained under weak implementation, the benefits of length limits are severely reduced. Still, length limits are projected to result in much lower fishing mortality and maintain biomass and fishery yields near MSY levels compared to the current fishery's selectivity and retention. Over the entire projection period, the high maturity length limit provided the highest probability of sustainable biomass and the highest mean relative yield under weak implementation and a growing future fishing effort. Our results underscore the benefits of implementing length limit regulation in sustaining data- and capacity-limited fisheries, particularly if current fishing conditions involve selecting and retaining small and immature fish under a high and growing fishing mortality rate.

Identifying stakeholder preferences for rebuilding a Canadian Atlantic redfish fishery—limitations and benefits of different opinion survey approaches

Fisheries management authorities seek to improve the incorporation of stakeholders’ preferences into decision-making but conventional approaches to assessing stakeholder viewpoints may risk under-representing a diversity of opinions. In Atlantic Canada’s units 1 and 2 redfish fisheries, there are competing visions about re-developing the fishery following historical overfishing. A management strategy evaluation (MSE) sought to identify which fishery objectives should guide the formulation of performance metrics. Following the MSE, we carried out a study to further sample the social, economic, and ecological objectives for the fishery using multiple questioning methods: i.e., workshops, questionnaires, and interviews. Results of interviews and questionnaires identified areas of consensus and complexity of opinion among the different groups (commercial, government and Indigenous), and showed that the workshop-based performance metrics defined in the MSE underrepresented the diversity of stakeholder preferences, particularly regarding social and economic goals. Multi-method and multi-disciplinary approaches to formalizing objectives are resource-intensive. However, there is value in applying multiple methods to systematically develop and formalize performance metrics that accurately reflect a diversity of stakeholders’ priorities for the fishery.

Small pelagic fish: new frontiers in science and sustainable management

Small pelagic fishes occupy an important trophic role in every global aquatic ecosystem, and many species are heavily exploited by fisheries, including some of the largest and most valuable capture fisheries in the world. In November 2022, a symposium on small pelagic fish titled “ Small Pelagic Fish: New Frontiers in Science and Sustainable Management” was cohosted by PICES, ICES, and FAO in Lisbon, Portugal. This special issue contains a collection of research manuscripts that explore approaches currently being used and developed to assess and manage small pelagic fishes. In particular, this issue covers topics on novel approaches to surveying small pelagic fishes, incorporating environmental covariates into management, management strategy evaluation, and aspects of the economics of small pelagic fisheries. The conclusions highlight the importance of new approaches that seek to enhance small pelagic fish surveys and ecosystem monitoring, incorporate that ecosystem information into management strategy evaluation, and predict the potential impacts of ecosystem changes on outcomes for economies and communities that rely on sustainable populations of small pelagic fishes.

MEXICAN PINK ABALONE (Haliotis corrugata WOOD, 1828) FISHERY MANAGEMENT STRATEGY EVALUATION: A DATA-LIMITED APPROACH

Management procedures (MP) were evaluated to address alternative management of the pink abalone (Haliotis corrugata) fishery in the Mexican Pacific. This assessment utilized the Method Evaluation and Risk Assessment (MERA) platform within the context of management strategy evaluation (MSE). This species has been a crucial component of the abalone fishery in Mexico, with a history dating back to the 19th century. Since 1996, fishery authorities and fishermen have noted a decline in the stock biomass. In response, they implemented various strategies and efforts to address the situation. However, despite these measures, the stock has yet to recover satisfactorily. Eight MP were evaluated, and two corresponded to the status quo (current catch and effort). The simulation results suggest that relying solely on effort-based MP falls short of meeting the management objectives set in the reference points (Biomass and Yield). In contrast, alternative strategies involving different quota allocation strategies (e.g., based on the depletion level) demonstrated superior performance and a higher likelihood of meeting management objectives. Despite incorporating fishery information, the existing management procedures could have performed better in the simulation. Therefore, it is crucial to assess and implement alternative management strategies that are more likely to succeed

Predicting relapsed/refractory disease in childhood hemophagocytic lymphohistiocytosis based on clinical features at diagnosis: A 13-year single-institute retrospective study in Thailand.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease. Relapsed/refractory disease is the main cause of death. This study aims to determine the prognostic indicators for relapsed/refractory disease in childhood HLH (R/R HLH). Infants and children under 18 years of age who were diagnosed with HLH according to HLH-2004 criteria, MAS-HLH criteria for rheumatologic diseases, or H-score undergoing treatment in Chiang Mai University hospital between 2010 and 2022 were included. Demographic data, clinical characteristics, and laboratory parameters were retrospectively reviewed. Out of 86 childhood HLH cases, 30 patients (34.9%) experienced R/R HLH. All patients with primary HLH developed R/R HLH. The most common form of secondary HLH was infection-associated hemophagocytic syndrome (IAHS), comprising 43 cases. Of these, 37.2% had relapsed or refractory disease. Univariable analysis identified several potential risk factors for R/R HLH, including younger age, severe disease status, higher HLH-2004 criteria scores, higher H-scores, overt DIC, higher pSOFA scores, and increased levels of aspartate aminotransferase, total bilirubin, and direct bilirubin. Multivariable logistic regression analysis revealed that a pSOFA score of ≥ 8 and age < 3 years were independent risk factors for R/R HLH, with adjusted odds ratios of 6.35 (95% confidence interval [CI], 1.18-34.19; P = 0.032) and 3.62 (95% CI, 1.04-12.63; P = 0.044), respectively. Children with HLH who have a pSOFA score of ≥ 8, or are younger than 3 years, are at a higher risk of relapsed or refractory disease. Further evaluation of management strategies in this context is warranted.

ALLERGIC CONJUNCTIVITIS IN CHILDHOOD

Allergic conjunctivitis is an eye condition prevalent among children, characterized by inflammation of the conjunctiva resulting from an allergic reaction to substances such as pollen, dust, dust mites and animal dander. This disease is a manifestation of the immune system and causes symptoms such as intense itching, tearing, hyperemia and a sensation of a foreign body in the eyes. The management of allergic conjunctivitis ranges from simple measures, such as frequent eye washing and avoidance of allergens, to the use of medications such as antihistamines, mast cell stabilizers and topical corticosteroids. In childhood, the management of allergic conjunctivitis faces difficulties such as variability in response to treatment and the impossibility of completely avoiding exposure to allergens. The general objective of this study is to evaluate management strategies for allergic conjunctivitis in childhood, with an emphasis on the effectiveness of available treatments and the identification of factors that influence the response to treatment. Specific objectives include analyzing the effectiveness of different treatments, investigating the influence of environmental and individual factors on disease severity and recurrence, and discussing the management of allergic conjunctivitis. This study is relevant as appropriate management of allergic conjunctivitis can prevent complications and improve children’s well-being. Identifying factors that influence response to treatment can contribute to the development of more personalized and effective therapeutic approaches. Recent literature highlights the need to improve education of parents and caregivers about allergic conjunctivitis to ensure appropriate management of the disease. Studies show that understanding the immunological mechanisms underlying the disease is crucial for developing new therapies. Therefore, this research not only adds to scientific knowledge about childhood allergic conjunctivitis, but also provides valuable insights for clinical practice and health policy formulation.

Empirical validation of integrated stock assessment models to ensuring risk equivalence: A pathway to resilient fisheries management.

The Precautionary Approach to Fisheries Management requires an assessment of the impact of uncertainty on the risk of achieving management objectives. However, the main quantities, such as spawning stock biomass (SSB) and fish mortality (F), used in management metrics cannot be directly observed. This requires the use of models to provide guidance, for which there are three paradigms: the best assessment, model ensemble, and Management Strategy Evaluation (MSE). It is important to validate the models used to provide advice. In this study, we demonstrate how stock assessment models can be validated using a diagnostic toolbox, with a specific focus on prediction skill. Prediction skill measures the precision of a predicted value, which is unknown to the model, in relation to its observed value. By evaluating the accuracy of model predictions against observed data, prediction skill establishes an objective framework for accepting or rejecting model hypotheses, as well as for assigning weights to models within an ensemble. Our analysis uncovers the limitations of traditional stock assessment methods. Through the quantification of uncertainties and the integration of multiple models, our objective is to improve the reliability of management advice considering the complex interplay of factors that influence the dynamics of fish stocks.

A scalable big data approach for remotely tracking rangeland conditions

Rangelands, covering half of the global land area, are critically degraded by unsustainable use and climate change. Despite their extensive presence, global assessments of rangeland condition and sustainability are limited. Here we introduce a novel analytical approach that combines satellite big data and statistical modeling to quantify the likelihood of changes in rangeland conditions. These probabilities are then used to assess the effectiveness of management interventions targeting rangeland sustainability. This approach holds global potential, as demonstrated in Mongolia, where the shift to a capitalist economy has led to increased livestock numbers and grazing intensity. From 1986 to 2020, heavy grazing caused a marked decline in Mongolia’s rangeland condition. Our evaluation of diverse management strategies, corroborated by local ground observations, further substantiates our approach. Leveraging globally available yet locally detailed satellite data, our proposed condition tracking approach provides a rapid, cost-effective tool for sustainable rangeland management.

Management strategy evaluation operating model conditioning: a swordfish case study

Evaluation of fish stock status is a key step for fisheries management. Tuna Regional Fisheries Management Organizations (t-RFMOs) are moving towards management strategy evaluation (MSE), a process that combines science and policy and depends on technical aspects, developed by scientists, designed to meet management objectives established by managers and other stakeholders. In the Indian Ocean, the current management advice for swordfish (Xiphias gladius) is based on an ensemble of 24 models considering four areas of uncertainty about the stock dynamics. There is an ongoing MSE process for swordfish, and this paper describes the methodology being applied for the conditioning of the operating model (OM), including model selection and validation. In the MSE, nine sources of uncertainty were considered, each being characterized by 2–3 levels. A partial factorial design was employed to reduce the number of models from a full factorial design to those needed to encompass the overall uncertainty. A selection and validation process was carried out, filtering models that converged, showed good predictive skills, and provided plausible estimates. Overall, the estimated spawning stock biomass (SSB) relative to SSB at maximum sustainable yield (MSY), and fishing mortality (F) relative to FMSY encompasses the estimates of the stock assessment ensemble at the most optimist area of the distribution. The MSE for swordfish is an ongoing process that is expected to provide more robust management advice in the future. Further developments to the OM can still occur, but the methods presented herein can be applied to this, or other species, MSE processes.

Interventional Prospective Studies on Xerostomia in Patients Undergoing Palliative and End-of-Life Care: A Scoping Review.

Patients undergoing palliative care often develop debilitating oral conditions, including xerostomia. These conditions may significantly impact patients' quality of life. Despite the high prevalence and adverse impact of xerostomia, effective management strategies remain unclear. This scoping review was performed to elucidate effective interventions for xerostomia in patients undergoing palliative and end-of-life care. A comprehensive search strategy was employed to identify relevant studies up to August 2023. Full-text primary articles focusing on xerostomia in patients receiving palliative care were included in the review. Eleven articles were selected for analysis, and data were extracted by six reviewers. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Among the 11 studies, interventions ranged from oral care to saliva substitutes and methods to stimulate saliva secretion. The primary method of assessing xerostomia was the performance of subjective evaluations using visual analog scale scores or numerical rating scale scores. Various interventions including oral care regimens, topical treatments, and mixed efficacy outcomes were reported. Notably, only one study directly measured the saliva volume, highlighting a reliance on subjective endpoints in most studies. Although no definitive conclusions can be drawn regarding the most effective intervention, oral care was a preferred option for managing xerostomia in patients undergoing palliative care. Additionally, adjunctive treatments such as ice cubes, saline, and moisturizers showed promise but require further investigation. Objective measures should be incorporated into future intervention trials to complement subjective assessments and provide a comprehensive evaluation of xerostomia management strategies in this patient population.

Real-World Treatment Patterns, Clinical Outcomes, Healthcare Resource Utilization, and Costs in Advanced Hepatocellular Carcinoma in Ontario, Canada.

The therapeutic landscape for aHCC has evolved in recent years, necessitating a comprehensive analysis of treatment patterns, clinical outcomes, HCRU, and costs to contextualize emerging treatments. This study aimed to investigate these outcomes using real-world data from Ontario, Canada. This retrospective cohort study was conducted using linked administrative databases from April 2010 to March 2020. Patients diagnosed with aHCC were included, and their clinical and demographic characteristics were analyzed, as well as treatment patterns, survival, HCRU, and economic burden. Among 7322 identified patients, 802 aHCC patients met the eligibility criteria for inclusion in the study. Treatment subgroups included 1L systemic therapy (53.2%), other systemic treatments (4.5%), LRT (9.0%), and no treatment (33.3%). The median age was 66 years, and the majority were male (82%). The mOS for the entire cohort from diagnosis was 6.5 months. However, patients who received 1L systemic therapy had an mOS of 9.0 months, which was significantly higher than the other three subgroups. The mean cost per aHCC-treated patient was $49,640 CAD, with oral medications and inpatient hospitalizations as the largest cost drivers. The results underscore the need for the continuous evaluation and optimization of HCC management strategies in the era of evolving therapeutic options.

A Review article of pharmacovigilance and studies of clinical research for health care

Pharmacovigilance, the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug- related problems, is intrinsically linked to effective information management. The pivotal role of information in pharmacovigilance encompassing data collection, analysis, and dissemination for optimal patient safety. The foundation of pharmacovigilance lies in robust information system that facilitate the collection of adverse event reports from healthcare professionals, patients, and other stakeholder. The evolution of data sources, emphasizing the integration of electronic health records, wearable devices and real world evidence to enhance the depth and breadth of information available for analysis. Innovative technologies, including artificial intelligence and machine learning, are transforming pharmacovigilance by automating signal detection and predictive modeling. How those tools are utilized to sift through vast datasets, identifying potential safety concerns and aiding regulatory decision-making. Furthermore, the abstract delves into the importance of structured information sharing between regulatory agencies, pharmaceutical companies, healthcare providers. Timely transparent communication of safety information ensure a proactive response to emerging risk and enable the development of effective risk management strategies.The continues evaluation of information management strategies to adapt to the complexities of modern healthcare and pharmaceutical innovation. In essence, this abstract illuminates the symbiotic relationship between pharmacovigilance and information management, showcasing how the effective utilization of diverse and high quality data is fundamental to advancing drug safety practices and safeguarding public health.

Developing management plans for sprat (Sprattus sprattus) in the Celtic Sea to advance the ecosystem approach to fisheries

Sprat are commercially valuable and are an important component of the North-East Atlantic ecosystem as major predators of zooplankton, competitors with herring, and prey for piscivorous fish, marine mammals, and seabirds. Despite this, insufficient information exists for Celtic Seas sprat, one of five North-East Atlantic stocks, to estimate stock status. To ensure the sustainable exploitation of sprat, the health of the Celtic Seas ecosystem, and the wider fisheries sector, we conduct a management strategy evaluation to stress test the current single-species advice framework. The aim is to evaluate whether ecosystem objectives can be achieved under single-species maximum sustainable yield and precautionary advice frameworks. An operating model was conditioned on life history theory and strategic information from ecosystem models. We showed that in-year advice using an empirical rule could achieve management objectives and help balance the trade-offs between fishing activities and ecosystem health. The approach allows ecosystem understanding to be incorporated within existing precautionary and maximum sustainable yield frameworks to provide a robust management framework that can meet multiple objectives despite uncertainty.

The second Irish Helicobacter pylori Working Group consensus for the diagnosis and treatment of Helicobacter pylori infection in adult patients in Ireland.

There has been an increase in resistance to many of the antimicrobials used to treat Helicobacter pylori ( H. pylori ) nationally and internationally. Primary clarithromycin resistance and dual clarithromycin and metronidazole resistance are high in Ireland. These trends call for an evaluation of best-practice management strategies. The objective of this study was to revise the recommendations for the management of H. pylori infection in adult patients in the Irish healthcare setting. The Irish H. pylori working group (IHPWG) was established in 2016 and reconvened in 2023 to evaluate the most up-to-date literature on H. pylori diagnosis, eradication rates and antimicrobial resistance. The 'GRADE' approach was then used to rate the quality of available evidence and grade the resulting recommendations. The Irish H. pylori working group agreed on 14 consensus statements. Key recommendations include (1) routine antimicrobial susceptibility testing to guide therapy is no longer recommended other than for clarithromycin susceptibility testing for first-line treatment (statements 6 and 9), (2) clarithromycin triple therapy should only be prescribed as first-line therapy in cases where clarithromycin susceptibility has been confirmed (statement 9), (3) bismuth quadruple therapy (proton pump inhibitor, bismuth, metronidazole, tetracycline) is the recommended first-line therapy if clarithromycin resistance is unknown or confirmed (statement 10), (4) bismuth quadruple therapy with a proton pump inhibitor, levofloxacin and amoxicillin is the recommended second-line treatment (statement 11) and (5) rifabutin amoxicillin triple therapy is the recommend rescue therapy (statement 12). These recommendations are intended to provide the most relevant current best-practice guidelines for the management of H. pylori infection in adults in Ireland.