National Accreditation Research Articles

Predictive Analysis System for National Ranking and Accreditation of HEIs

Predictive analytical models have been applied in context of the Indian higher educational institutions dataset. This study is aimed to compare the predictive accuracy level of various machine learning algorithms (multi-class classification prediction algorithms) to assess the grading system applicable to a college based on various parameters outlined by NAAC (National Assessment and Accreditation Council). NAAC is an apex body to assess and accredit HEIs of India. An ensemble classification method is proposed to best predict the academic grading of university-affiliated colleges of India for the NAAC accreditation system. This maiden attempt for using PA (Predictive Analysis) on such institutional credential data would be beneficial to colleges applying for NAAC accreditation to judge their grade prior to final assessment. Thus they would be able to identify their strengths and weaknesses and eventually work towards further improving upon their grade. Such a system would pave the way for designing such predictive systems to assess the institutional rankings for several other assessment systems.

Is Early, Post-Induction Restaging of Rectal Cancer Undergoing Total Neoadjuvant Therapy Associated With Ultimate Treatment Response?

Among rectal cancer patients treated with Total Neoadjuvant Therapy, it is unclear whether early, post-induction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making. To determine if post-induction restaging with endoscopy and magnetic resonance imaging is associated with final tumor response. Retrospective cohort study. US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer. Biopsy-proven rectal cancer patients who underwent Total Neoadjuvant Therapy with interim (post-induction) restaging. Association between response assessment on post-induction restaging and final treatment response. 107 patients were analyzed. Patients with post-induction magnetic resonance tumor response grade 1 - 2 or complete endoscopic response were significantly more likely (odds ratio 5.4 [p < 0.01] and odds ratio 3.7 [p = 0.03], respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with post-induction composite partial (odds ratio 4.1, p < 0.01) or minimal (odds ratio 12.0, p < 0.01) responses. Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of this data. Limited sample size may also have biased these conclusions. Tumor response to induction therapy is associated with ultimate treatment response to Total Neoadjuvant Therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract.

Overcoming Barriers to Healthcare Reform: A Call to Action.

The success of healthcare reform hinges on policymaker, regulator, and administrator actions that shape policies at various levels. These policies can either facilitate or hinder the practice of healthcare professionals and collaborative work environments. It is imperative for all healthcare professionals to fully utilize their education and certification, as fostering an equitable workplace culture is vital for retaining staff and improving access to care. Using nurse practitioners (NPs) as an exemplar, this article aims to specify systemic barriers to healthcare reform and call for policymakers, regulators, and clinical agency administrators to enact change. Barriers to NP practice include restrictive oversight by external stakeholders, financial incentives for indirect billing, and hierarchical constraints that limit NP contributions to the healthcare system. The growing healthcare provider shortage disproportionately impacts primary care and rural settings. NPs are increasingly more likely to fill these roles than medical doctors and have documented positive patient health outcomes. Removing systemic obstacles for NP practice increases access to care. Nursing-the largest healthcare workforce with diverse roles-operates under complex oversight from multiple organizations for licensure, accreditation, certification, and education. The recent trend of external stakeholders influencing and requiring additional oversight has created barriers to nursing practice. Despite national education, accreditation, and certification standards, nursing licensure and practice are increasingly negotiated with external stakeholders and supervised at the state and institutional levels. Supporting all healthcare professionals to practice according to their education and certification can advance healthcare reform, address workforce shortages, increase access to care, and improve health.

Patient-reported observations on medical procedure timeliness (PROMPT) in breast cancer: a qualitative study.

Timeliness of care is an important healthcare outcome measure. The objective of this study was to explore patient perspectives on the timeliness of breast cancer diagnosis and treatment at accredited breast cancer centers. In this qualitative study, 1hour virtual interviews were conducted with participants 18-75years old who were diagnosed and treated for stage 0-III breast cancer at a National Accreditation Program for Breast Centers facility from 2018 to 2022. Thematic analysis was used to identify key themes of participant experiences. Twenty-eight participants were interviewed. Two thematic domains were identified: etiologies of expedited or delayed care and the impact of delayed or expedited care on patients. Within these domains, multiple themes emerged. For etiologies of expedited or delayed care, participants discussed (1) the effect of scheduling appointments, (2) the COVID-19 pandemic, (3) dissatisfaction with the timeline for various parts of the diagnostic workup, and (4) delays related to patient factors, including socioeconomic status. For the impact of expedited or delayed care, patients discussed (1) the emotional and mental impact of waiting, (2) the importance of communication and clear expectations, and (3) the impact of electronic health portals. Patients desired each care interval (e.g., the time from mammogram to breast biopsy) to be approximately 7days, with longer intervals sometimes preferred prior to surgery. These patient interviews identify areas of delay and provide patient-centered, actionable items to improve the timeliness of breast cancer care.

Temporal and geogrpahic trends in female representation within European cardiovascular imaging among 13,436 individuals associated with EACVI

Abstract Introduction Women are under-represented in cardiology trial enrolment, specialty training, faculty, scientific authorship and board membership in cardiology journals and societies. An EACVI Task Force on Women in Cardiovascular Imaging aims to promote women’s representation and leadership, but data is lacking in this area. Purpose To characterise the representation of women in cardiovascular imaging within Europe and examine temporal and geographic trends. Methods We scraped publicly available name data from over 100 online sources including EACVI taskforces, committees, research project members, consensus and position paper authors, board membership and past presidents alongside members of affiliated cardiovascular imaging national societies and working groups. We also included names from EACVI or national accreditation records for cardiac imaging. We recorded data on country location and year of affiliation. We defined gender in a binary manner as either male or female. The previously validated artificial intelligence (AI) system Namsor assigned gender based on name morphology and geolocation data. We pre-set a confidence of gender-name matching of 95%. Results The AI was able to assign gender at 95% confidence to 12,643/13,436 (94.1%) names. The overall number of names assigned female gender was 5903/12643 (46.7%), rejecting the null hypothesis that gender was equally distributed (i.e. 50% female) [p&amp;lt;0.0001]. Among the 9712 individuals with year of affiliation we observed female representation to increase over time: 1989-2000 4/18 (22.2%), 2001-2004 107/287 (37.8%) 2005-2009 77/170 (45.3%), 2010-2014 109/203 (53.7%), 2015-2019 1063/2022 (51.3%) and 2020-2024 3352/3064 (52.2%) (Cochran-Armitage trend test 24.196 [p&amp;lt;0.0001]) (Figure 1). Female representation was lower in countries outside of Europe, compared to within Europe; 740/2654 (27.9%) vs. 5163/9989 (51.7%) [p&amp;lt;0.0001]. The lowest rate of female representation was in Saudia Arabia (15.1%), the highest in Lithuania (83.3%). Figure 2 displays a choropleth of gender representation (%) between European countries with n&amp;gt;20. Conclusion(s) There are significant limitations in this form of analysis, including that we have arbritarily defined gender in a binary format, thereby excluding individuals who do not identify with such a social construct. It is also likely that the excluded names based on the 95% confidence of the AI software disproportionately represents individuals from ethnic minorities. However, our data provides a basic understanding of the representation of women in European cardiovascular imaging over time and between countries. We observed a trend of increasing female participation but with substantial variation between countries both inside and outside of Europe. This data may be useful to refine and direct efforts to improve female representation in areas in which it is needed most.

How Well Are Surgical Quality Improvement Projects Planned? Review of 242 Surgical Improvement Efforts Across Five American College of Surgeons Quality Programs.

Structured preparation is necessary to conduct quality improvement (QI) strategies that are relevant to the problem, feasible, appropriately resourced, and potentially effective. Recent work suggests improvement efforts are sub-optimally conducted. Our goal was to determine how well preparation for surgical QI is undertaken, including detailing the problem, setting project goals, and planning an intervention. This retrospective cross-sectional study included QI efforts submitted in 2019 to the American College of Surgeons (ACS) during review for accreditation across five ACS Quality Programs: Children's Surgery Verification (CSV), the Commission on Cancer (CoC), the Metabolic and Bariatric Surgical Accreditation and Quality Improvement Program (MBSAQIP), the National Accreditation Program for Breast Centers (NAPBC), and the Trauma Verification Program. Projects were scored for alignment with three components of the pre-conduct phase of the ACS Quality Framework: problem detailing, goal specification, and strategic planning. 242 projects satisfied inclusion criteria and were scored. Most projects in the final cohort were from MBSAQIP (36%), CoC (31%), or NAPBC (29%) programs. The average overall pre-conduct score was 52% (Standard Deviation (SD)=17). On average, projects performed best in the 'Goal Specification' component (65% SD=27), followed by 'Problem Detailing' (52% SD=16), and 'Strategic Planning' (44% SD=25). Within these components, identification of possible limitations (5%) and consideration of contextual issues (12%) were among the least frequently reported items. Thorough planning is a critical component of effective QI, and our study reflects significant opportunity for its improvement. The ACS Quality Framework may serve as a guide to improve QI planning, thereby promoting efficiency and effectiveness of these efforts.

Enhancing the accreditation of Indonesian private universities through the integration of EduQual and accreditation standards of the BAN-PT

Higher education institutions in Indonesia are currently facing significant challenges in maintaining public trust, requiring them to uphold autonomy, transparency, accountability, and continuously meet standards for quality assurance and improvement. This research aims to identify and address the unmet quality aspects in education to elevate the accreditation of private universities from C/Good to B/Very Good or even A/Excellent. By integrating the EduQual model with certification requirements from the Board of National Accreditation for Higher Education (Badan Akreditasi Nasional Perguruan Tinggi, BAN-PT), the research is supported by comprehensive studies of university accreditation reports, questionnaires, focus group discussions (FGD), and expert judgment through interviews and consultations. The data analysis employs gap analysis, importance-performance analysis, and quality function deployment. The study identified twenty-one priority improvement points to enhance accreditation, with six key improvements prioritized from the ninety indicators examined based on customer needs analysis. In the accreditation of private universities, the unmet aspects of education quality lie in the dimension of physical facilities, particularly human resources, as well as in the dimension of personal development, especially in the criteria for research and community service. The study recommends prioritizing investments in human resource development and strengthening research and community service initiatives, as these are critical areas where private universities fall short in meeting accreditation standards and fulfilling educational quality expectations.

The Effect of the Adoption of the National Accreditation Program for Rectal Cancer Process on Compliance Standards at a Single Institution.

Background: The National Accreditation Program for Rectal Cancer (NAPRC) was developed to enhance the quality of rectal cancer care in the United States. This project compared NAPRC compliance at a single tertiary care academic hospital before and after the institution adopted these standards in 2019. Methods: Rectal cancer patients from 2016 to 2023 who met NAPRC eligibility criteria were retrospectively reviewed for compliance with pre-selected patient care standards. Patients diagnosed prior to August 1, 2019 (pre-NAPRC) were compared with those diagnosed afterward (post-NAPRC) to determine whether compliance with these standards differed following the institution's adoption of new guidelines. Results: This study included 353 patients, 146 pre-NAPRC and 207 post-NAPRC. The post-NAPRC group demonstrated significantly higher compliance with pretreatment standards compared to the pre-NAPRC group, including attaining magnetic resonance imaging (MRI) (P = .015), computed tomography (CT) (P < .001), and a carcinoembryonic antigen (CEA) level (P < .001). Postoperative standards were more frequently met in the post-NAPRC group regarding the photographing of surgical specimens (P < .001). No significant differences were observed in confirming a tissue diagnosis, starting treatment within a 60-day timeframe, or completing surgical pathology reports. Prior to initiation of the NAPRC process, the institution had achieved accreditation-level compliance in 2 of the 7 standards. Within 2years of adopting NAPRC standards, complete compliance was met in 6 of the 7 measures. Conclusions: A single institution's adoption of NAPRC standards improved compliance with multiple rectal cancer care standards, achieving near-complete accreditation level compliance within 2years.

Проблемні питання забезпечення якості дорожньо-будівельних матеріалів та виробів в контексті особливостей їх сертифікації в Україні відповідно до ДСТУ EN ISO/IEC 17065:2019 та закону України «Про надання будівельної продукції на ринку»

Introduction. The article examines the importance of certification of road construction materials as one of the main tools for ensuring their quality. Problems. The authors emphasize that the certificate of conformity is a key document that confirms that the products meet the established regulatory requirements. Product certification, which includes laboratory tests and control of the production process, ensures the objectivity of quality assessment. The article describes in detail the stages of the certification process, from submitting an application to technical supervision of certified products. The role of certification bodies, which must be accredited by the National Accreditation Agency of Ukraine (NAAU), is emphasized separately, and their responsibility for the safety and quality of certified road construction materials is also noted. The authors also draw attention to the problem of non-compliance with the quality standards of road construction products in Ukraine, which leads to road defects, such as cracks and subsidence, which can appear already a year after the road is put into operation. In this context, it is emphasized the need to strengthen the quality control of both produced in Ukraine and imported road construction materials. The article also considers the issue of voluntary certification of road construction products, which is carried out at the initiative of the manufacturer or supplier, which is becoming more and more important in the conditions of tender procurement. At the same time, the lack of quality control of products sold through retail networks and the lack of effective quality control of imported road construction materials are emphasized.

Labour rights protection and export expansion: Evidence from SA8000 certification

Protecting labour rights is an important approach to shaping the new advantages of trade competition and achieving high-quality development of China’s export trade. This paper considers SA8000 certification as the criterion for labour rights protection and manually collects information from firms certified by the National Certification and Accreditation Administration of China. Next, we investigate the effects of SA8000 certification on firm exports. The results show that SA8000 certification significantly expands the export scale while improving export quality. The mechanism analysis shows that the improvement effects are achieved in three ways: reducing operating costs, improving social reputation and increasing labour efficiency. Moreover, the positive effects of SA8000 certification are more profound for resource-intensive firms, non-state-owned firms and large firms. Our study provides an important reference for safeguarding labour rights and reconstructing new competitive advantages in exports.

Surviving to thriving: Virtual nutrition education in patients with breast cancer

IntroductionImproved outcomes in the treatment of breast cancer has increased the importance of formal survivorship. National guidelines and accreditation standards require institutional survivorship programs; however, implementation presents operational challenges. While existing literature affirms the need for clinician involvement in survivorship, applicability to virtual formats is unknown. Here we report our 3-year experience with design and implementation of virtual nutrition workshops in breast cancer survivorship. Materials and methodsFree virtual workshops were developed by an interdisciplinary team and offered to eligible participants on a quarterly basis. Workshop content focused on diet, nutrition, and exercise in cancer prevention, development, and recurrence. A question-and-answer session addressed misconceptions about nutrition and cancer. Participants were invited to participate in an evaluation survey after each workshop. Post-workshop assessment of course effectiveness was performed with a four-point Likert scale and qualitative comments. Results116 women participated in the workshops. Quarterly attendance consistently grew and averaged sixteen participants per session. Post workshop surveys demonstrated significant improvements in participants’ knowledge, and likelihood of behavioral modification. 93 % of participants had the highest rating for likelihood of making a change to their diet, and 83 % for likelihood of making changes to physical activity. Qualitative feedback supported both the effectiveness of the education as well as the virtual group setting. ConclusionsVirtual group workshops are effective for survivorship education. They present a feasible way to improve access to oncologic-trained dieticians for low-acuity concerns. The realistic design affords itself to easy reproducibility in other institutions seeking to implement disease-specific survivorship programs.

Defining the Need for Services for Patients at High Risk of Breast Cancer at a Safety-Net Hospital: An Approach to Narrowing the Disparities Gap.

The National Accreditation Program for Breast Cancer (NAPBC) standards were recently revised to promote breast cancer (BC) risk assessment and subsequent referral for high-risk services. This project sought to estimate the proportion of patients at high risk for BC in the authors' safety-net hospital system, gauge patient interest in high-risk services, and define resources for program development. Women presenting for breast imaging during 2 weeks in 2023 were surveyed. Thirty-five patients with a history or diagnosis of BC were excluded. The Tyrer-Cuzick (TC) model version 8 was used to calculate BC risk. High/intermediate risk was defined as a 10-year risk of 5% or more, a lifetime risk of 15% or more, or both. The criteria for genetic counseling and testing referral were based on National Comprehensive Cancer Network guidelines. A total of 257 patients had a TC risk assessment showing 14.8% (n = 38) with a 10-year BC risk of 5% or more (consideration of endocrine therapy), 6.2% (n = 16) with a lifetime BC risk of 20% or more (qualifying for annual screening MRI), and 10.5% (n = 27) with a lifetime BC risk of 15% or more (consideration of high-risk screening). The criteria for genetic counseling/testing were met by 61 (23.7%) of the 257 patients. Overall, 31.5% (n = 81) qualified for high/intermediate-risk screening, risk reduction, and/or genetic assessment/testing, 92.8% of whom were interested in referrals for additional information and care. In the authors' community, almost one third of patients undergoing breast imaging qualify for BC high-risk assessment and services. The majority of the patients expressed interest in pursuing such services. These data will be used in financial planning and resource allocation to develop a high-risk program at the authors' institution in line with NAPBC guidelines. They are hopeful that these efforts will improve oncologic outcomes and survival from BC in their community.

Reducing Unnecessary Transfusions of RBCs in Inpatients Admitted Across Niagara Health Community Hospitals.

Blood products are scarce resources. Audits on the use of red blood cells (RBCs) in tertiary centers have repeatedly highlighted inappropriate use. Earlier retrospective audit at our local community hospitals has demonstrated that only 85% and 54% of all requests met Choosing Wisely Canada guidelines for pre-transfusion hemoglobin (Hb) of 80 g/L or less and single unit, respectively.We sought to improve RBC utilization by 15% over a period of 12 months (meeting Choosing Wisely Canada criteria of pre-transfusion Hb ≤80g/L by >80% and single-unit transfusion by >65%). Following repeated PDSA (Plan-Do-Study-Act) cycles, we implemented educational strategies, prospective transfusion medicine (TM) technologist-led screening of orders, and an RBC order set. The 3-month median percentages of appropriate RBC use for pre-transfusion Hb and single unit (September-November 2021) across all 3 hospitals were 90% and 71%, respectively. Overall, the rate of appropriate RBCs based on pre-transfusion Hb remained above target (>80%), with minimal improvement across all hospitals (median percentage at pre- and post-technologist screening periods of 87% and 90%, respectively). The median percentage of appropriate RBCs based on single-unit transfusion orders has improved across all Niagara Health hospitals with sustained targets (3-month median percentage at pre- and post-technologist screening and most recent time periods of 54%, 56%, and 71%, respectively). We have taken a collaborative, multifaceted approach to optimizing utilization of RBCs across the Niagara Health hospitals. The rates of appropriate RBC use were comparable with the provincial and national accreditation benchmark standards. In particular, the TM technologist-led screening was effective in producing sustained improvement with respect to single-unit transfusion. One of the balancing outcomes was increasing workload on technologists. Local and provincial efforts are needed to facilitate recruitment and retention of laboratory technologists, especially in community hospitals.

Clinical effects of accreditation in general practice: a pragmatic randomized controlled study.

Accreditation has been implemented in general practice in many countries as a tool for quality improvement. Evidence of the effects of accreditation is, however, lacking. To investigate the clinical effects of accreditation in general practice. A mandatory national accreditation programme in Danish general practice was rolled out from 2016 to 2018. General practices were randomized to year of accreditation at the municipality level. We conducted a pragmatic randomized controlled study with general practices randomized to accreditation in 2016 (intervention group) and 2018 (control group). Data on patients enlisted with these practices were collected at baseline in 2014 (before randomization) and at follow-up in 2017. We use linear and logistic regression models to compare differences in changes in outcomes from baseline to follow-up between the intervention and control groups. The primary outcome was the number of redeemed medications. Secondary outcomes were polypharmacy, nonsteroidal anti-inflammatory drugs (NSAIDs)without proton pump inhibitors, sleeping medicine, preventive home visits, annual controls, spirometry tests, and mortality. We found statistically significant effects of accreditation on the primary outcome, the number of redeemed medications, and the secondary outcome, polypharmacy. No other effects were detected. In this first randomized study exploring the effects of accreditation in a primary care context, accreditation was found to reduce the number of redeemed medications and polypharmacy. We conclude that accreditation can be effective in changing behaviour, but the identified effects are small and limited to certain outcomes. Evaluations on the cost-effectiveness of accreditation are therefore warranted.

Modeling appeals in university accreditation in Chile: an exploratory study

ABSTRACT In Chile, university administrators may appeal to a secondary agency to challenge the accreditation decisions of the primary national accreditation agency. The study analyzes the appeal judgments, using an empirical approach to identify arguments used by the secondary agency to justify its decisions. The analyses identify several factors, such as improvements since the last accreditation, faculty productivity, and financial standing, as the most relevant predictors of appeal success. The appellate agency, however, tends to emphasize the absence of deficiencies or weaknesses associated with these factors when it grants an appeal, sidestepping the primary agency’s criteria and standards for accreditation. Such an approach may be appropriate given the heterogeneous landscape of the Chilean higher education system, providing leeway to drive excellence in more selective institutions while maintaining some minimum standards in less selective ones.

Evaluation of the current status of ethics committees in India using the National Accreditation Board for Hospitals and Health-care Providers, Central Drugs Standard Control Organization (CDSCO), and Department of Health Research databases

Evaluation of the current status of ethics committees in India using the National Accreditation Board for Hospitals and Health-care Providers, Central Drugs Standard Control Organization (CDSCO), and Department of Health Research databases

Profile of Hospitals Accredited By The Seal of The National Accreditation Organization (ONA)

Profile of Hospitals Accredited By The Seal of The National Accreditation Organization (ONA)

Exploring the Implementation of “Merdeka Belajar Kampus Merdeka” in Indonesian Islamic Universities

“Merdeka Belajar Kampus Merdeka” (MBKM) is an Indonesian government program launched to improve students’ skills and competencies, both hard and soft skills. This study aims to analyze the implementation strategy of the “Merdeka Belajar Kampus Merdeka” (MBKM) program in Islamic Religious Colleges (PTKI) in Indonesia. Using a qualitative approach and a multi-case study method, this study examines the implementation of MBKM in Islamic religious colleges in Indonesia. Data were collected through in-depth interviews, observation and documentation. Data were analyzed using multi-case analysis techniques, starting from single case analysis/individual case and continuing with cross-case analysis/cross-case analysis. After being analyzed, data validity was checked through the degree of certainty, transferability, and trustworthiness. The results of this study indicate that implementing MBKM in PTKI uses a curriculum overhaul and adaptation strategy. The curriculum overhaul is implemented through learning innovation programs, collaboration, learning opportunities, eight program learning opportunities, character education, and curriculum models. Implementing curriculum adaptation is carried out through the ease of opening new study programs, study program accreditation, and the right to study outside the program for three semesters. The MBKM program is evaluated internally through internal quality audits and externally through national and international accreditation.

The variation in post-endoscopy upper gastrointestinal cancer rates among endoscopy providers in England and associated factors: a population-based study.

Post-endoscopy upper gastrointestinal cancer (PEUGIC) is an important key performance indicator for endoscopy quality. We examined variation in PEUGIC rates among endoscopy providers in England and explored associated factors. The was a population-based, retrospective, case-control study, examining data from National Cancer Registration and Analysis Service and Hospital Episode Statistics databases for esophageal and gastric cancers diagnosed between 2009 and 2018 in England. PEUGIC were cancers diagnosed 6 to 36 months after an endoscopy that did not diagnose cancer. Associated factors were identified using multivariable logistic regression analyses. The national PEUGIC rate was 8.5%, varying from 5% to 13% among endoscopy providers. Factors associated with PEUGIC included: female sex (odds ratio [OR] 1.29 [95%CI 1.23-1.36]); younger age (age >80 years, OR 0.52 [0.48-0.56], compared with ≤60 years); increasing comorbidity (Charlson score >4, OR 5.06 [4.45-5.76]); history of esophageal ulcer (OR 3.30 [3.11-3.50]), Barrett's esophagus (OR 3.21 [3.02-3.42]), esophageal stricture (OR 1.28 [1.20-1.37]), or gastric ulcer (OR 1.55 [1.44-1.66]); squamous cell carcinoma (OR 1.50 [1.39-1.61]); and UK national endoscopy accreditation status - providers requiring improvement (OR 1.10 [1.01-1.20]), providers never assessed (OR 1.24 [1.04-1.47]). PEUGIC rates varied threefold among endoscopy providers, suggesting unwarranted differences in endoscopy quality. PEUGIC was associated with endoscopy findings known to be associated with upper gastrointestinal cancer and a lack of national endoscopy provider accreditation. PEUGIC variations suggest an opportunity to raise performance standards to detect upper gastrointestinal cancers earlier and improve outcomes.

National Education and Accreditation of the Cadastral Surveyors in Türkiye

National Education and Accreditation of the Cadastral Surveyors in Türkiye